Affordable Medicines Programme: what are the development priorities for 2024?

The government is constantly working to expand the availability of the Affordable Medicines reimbursement programme so that more and more patients can receive the medicines they need free of charge or with a partial co-payment. The cost of medicines under the programme is reimbursed by the National Health Service of Ukraine.

This was emphasized by the Minister of Health Viktor Liashko during the online discussion “Changes in access to medicines for Ukrainians during the war”, supported by the USAID’s Activity “Safe, Affordable and Effective Medicines for Ukrainians” (SAFEMed).

According to the head of the Ministry of Health, the programme includes more than 500 trade names of medicines and products. In total, the state has allocated UAH 5.2 billion for the reimbursement programme in 2024, which is UAH 500 million more than last year. 

"The main priority for this year will be to increase the availability of medicines so that people with chronic diseases can take their medicines continuously and have access to them. To this end, last year we simplified the conditions for opening pharmacies in rural areas and frontline regions as much as possible. This, in particular, has already allowed us to launch the first mobile pharmacy units. They are already operating in the Kharkiv and Cherkasy regions. Also the pilot project "Ukrposhta. Pharmacy", thanks to which Ukrainians can receive medicines by mail, having pre-ordered them through the contact center, started in Donetsk region and in some border areas of Sumy region. Delivery is free. Other frontline regions are planned to be included later. It is very important that in this way it is possible to obtain medicines under the "Affordable Medicines" programme. This will allow patients to save their money," the Minister stressed. 

The Head of the National Health Service of Ukraine, Natalia Husak, added that in 2023, painkillers for palliative care patients, immunosuppressive drugs and test strips for determining blood glucose levels in type I diabetes were added to the list of the reimbursement programme for the first time. 

In total, almost 4.5 million patients have already benefited from the “Affordable Medicines” program under the administration of the National Health Service during the 5 years of operation, more than 2.2 million of them in 2023. Most patients have received medicines in the following areas: cardiovascular diseases; prevention of heart attacks and strokes; type II diabetes mellitus; chronic lower respiratory diseases; diabetes (insulin-dependent).

Natalia Husak said the biggest challenge is to increase the availability of medicines for Ukrainians in rural areas. 

"The average distance for a Ukrainian to reach a pharmacy in a village is 7 km. There are cases when a patient has to travel 17-25 km to the nearest pharmacy to fill a prescription for "Affordable Medicines", which is why many people do not do it. For example, in the villages of Kyiv region, only 26% of prescriptions are filled, while the number in Kyiv is 101%. We are now working to overcome these challenges in cooperation with local governments," said the Head of the NHSU.

Over the years, USAID has supported Ukraine in building a health care system that is more transparent, patient-centered, and resilient. Since the introduction of the reimbursement program Affordable Medicines in 2017, USAID has been closely cooperating with the Ministry of Health, the National Health Service of Ukraine and other stakeholders.

"USAID provided technical and legal support for successful transition of the reimbursement program from the MOH to the NHSU back in 2019, working closely with the newly established service to ensure that it was fully prepared to manage the program independently. Today, the Affordable Medicines Program continues to demonstrate remarkable resilience, adaptability, and maturity," said the Acting Director of the Office of Health, USAID Tara O'Day. 

The results of a study conducted by SAFEMed project showed that 80% of patients have been using the Affordable Medicines programme for more than a year, and 78% of respondents reported that the cost of treatment had decreased while using the programme.

Those who have been using the programme for more than two years highlighted electronic prescriptions, an expanded list of medicines, and the convenience of receiving treatment for long-term conditions as the most positive changes. 

Technical advisor of the SAFEMed project Anna Bezruk noted that the survey was conducted among patients, doctors and pharmacists in 20 regions of Ukraine. For more information on the results, please follow the link: https://bit.ly/42SNCHf. 

"77% of the doctors surveyed believe that the programme has improved patients' access to medicines. Doctors noted that patients can now take a continuous course of treatment and control their chronic diseases, and that the programme increases people's motivation to take treatment, as they know that they will be able to receive medicines on a regular basis," said Anna Bezruk.

Among the recommendations for improving the “Affordable Medicines” programme, given by the survey participants, Anna Bezruk highlighted the need to consider expanding the list of existing medicines to include diseases that are not currently covered by the programme, in particular, the respondents mentioned oncological diseases and basic antibiotics. 

Physicians interviewed for the study also noted the need to involve physicians in the process of selecting medicines for the programme and to provide more complex combinations of medicines that meet the treatment needs of patients.

To use the “Affordable Medicines” program, you need to contact a doctor and get an electronic prescription. Then visit a pharmacy marked “Here are the Affordable Medicines” and receive medicines free of charge or with a partial co-payment. Detailed instructions are available here: https://moz.gov.ua/dostupni-liki,