The article examines the problem of territorial and economic accessibility of medical care for the rural population of Russia, which makes up about a quarter of the country's inhabitants. It has been revealed that federal innovations — the sale of medicines through district hospitals, simplification of licensing of medical organizations, and an experiment with mobile pharmacy facilities for the period 2026—2029 — open up the possibility of integrating the pharmacy circuit into the state program for integrated rural development. An organizational and economic model based on the “hub — dispensing channels” principle is proposed, combining an inpatient pharmacy, a point at a paramedic—obstetric station, a pick-up point and a mobile format, with a system of controlled indicators of territorial, temporary, assortment and price accessibility; the illustrative calculation shows that the annual maintenance of accessibility is estimated at about 922 rubles per rural resident. It is concluded that the transfer of pharmaceutical accessibility from an optional health function to a mandatory infrastructure standard in rural areas is a reasonable institutional measure that requires pilot testing in the constituent entities of the Russian Federation.

rural areas, medical care, pharmacy network, availability of medicines, mobile pharmacy, preferential drug provision, mixed financing, food and drug safety.