Ukraine’s Healthcare Ministry introduces two mechanisms that are to make medicines cheaper and more accessible for low-income persons. To achieve that reference pricing as well as reimbursement for medicines included into the National medicines list will be introduced, said Ulana Suprun, acting Minister of Healthcare, and Roman Ilyk, Deputy Minister of Healthcare, at a press-briefing at Ukraine Crisis Media Center. “First steps of the program including both reference pricing and reimbursement will be in place already on January 1, 2017,” noted Suprun.
Reference pricing to decrease prices on medicines
Ulana Suprun noted that at the moment due to the lack of control over pricing on the pharmaceutical market medicines in Ukrainian drug stores are often more expensive than in the neighboring countries. Patients pay for ninety per cent of the medicines themselves, they do not always have money for that. In order to address the misbalance the Ministry suggests introducing reference pricing for medicines. “It includes both external reference pricing – comparison with the prices of our neighbors, as well as internal reference pricing – comparison between different regions inside Ukraine,” Suprun said.
“We will conduct reference pricing for medicines based on the International Nonproprietary Names (INN) as well as set the maximum price on medicines on the Ukrainian market. It concerns public procurement at various budget levels,” noted Ilyk.
100% or partial reimbursement of drug prices for patients
Reimbursement program foresees reimbursement of medicine prices that the patient is purchasing based on doctor’s prescription. “Patient who has turned for primary medical assistance and received doctor’s prescription, then turns to a drug store and gets free or partially reimbursed medicines that are included into the reimbursement program,” explained Ilyk.
Cardiovascular, diabetes and asthma medicines are planned to be included into the 2017 reimbursement list. “Technical issues are being settled now. We hope that in the nearest time respective documents – draft regulations of the Cabinet of Ministers, will be adopted by the government,” Deputy Healthcare Minister noted.
Ulana Suprun said that there were attempts to introduce such programs earlier, but they resulted in a serious problem as the program was based on trade names not on INN. This drawback is to be removed this time.
National list of medicines is shortened and adjusted to INN
“We have set the goal to get the updated national list of medicines by the end of the year,” said Roman Ilyk. It is part of the draft national policy on medicines that the Healthcare Ministry is working on. There are about a thousand medicine names. “Our task is to shorten it at least three times. It needs to include the medicines that are recommended by the WHO and are most efficient,” Deputy Minister explained. Only the medicines that have proof of efficiency and that are part of international protocols for treatment of patients will be left in the list. He said a specialized expert committee had been established, it has started working.
Changes will break corrupt practices
Ministry’s leadership noted that the shift from trade names to INN in the national list, reference pricing and prescribing medicines based on INN will allow to break traditional corrupt practices and established monopolies on the pharmaceutical market.
“Everyone is speculating over three things today: the medicine’s name, dosage form and dosing. It is subject to corruption almost in all procurement cases. As long as what we are purchasing is not unified and clearly defined in the procurement form, speculations will continue,” noted Roman Ilyk. Ulana Suprun said that it would not be possible to speculate in favor of a certain company at the stage of prescription as the prescriptions in treatment protocols will be based on INN as well.
According to Suprun the changes will open the market for many pharmaceutical companies and distributors. “It will be now based on INN, everyone will get the rules and access to public programs. All honest producers and distributors, and, what’s important, our patients will benefit from it,” she said. Roman Ilyk emphasized that there is no threat for Ukrainian pharmaceutical companies to be forced out of the market. “Detailed analysis based on INN of medicines that are to be compared shows that majority of medicines if not all of them are being produced by leading Ukrainian pharmaceutical producers. All those who support honest, transparent and open competition are welcome,” he said.
Ilyk said that it is quite possible that pharmaceutical companies are likely to seriously oppose. However, in his opinion “when they see that there is revenue and the mechanism is working, everyone will take part.” “If the government disburses a billion hryvnia for the program, I think everyone will be interested in joining the project – starting from producers and ending up with drug stores,” he added.
According to the Deputy Minister it is unlikely that corrupt agreements will take place, Antimonopoly Committee, State Service on Medicines can be involved if needed as well as other mechanisms stipulated by law.
Organization that will deal with public procurement to be created in Ukraine
Acting Minister Suprun aslo said that the Healthcare Ministry starts creating a Ukrainian organization that will deal with public procurement of medicines – it is what international organizations are now actually doing. “In 2018 we plan to have at least three programs implemented through this organization, while in 2019, if everything goes as planned, the organization will take up all the public procurement functions,” elaborated Suprun. All regional-level procurement requests will be sent to this organization.
“We will be able to not only procure medicines for Ukrainian market, but our Ukrainian producers will be able to sell their medicines internationally. We have producers with medicines of international quality level, and we have best prices,” Suprun added. The organization’s model and mechanism of work are currently being discussed.