ABSTRACT
OBJECTIVES: In 2017, the government of Ukraine introduced the new Affordable Medicines Program (AMP) for outpatient prescription medicines reimbursement. Despite the evident program implementation benefits, it is highly important to examine the AMP framework to reveal its current tendencies, strengths, and shortcomings that might be useful to support further development and improvement of reimbursement models. This study aimed to evaluate how the pricing strategies applied by the AMP framework might affect the potential to provide patients with affordable medicines. METHODS: The AMP framework has been evaluated by several parameters characterizing the pricing mechanisms, pharmaceutical manufacturers, the scope of medicines covered by the program, and consumption volumes. The data were collected from official government databases and open sources. The statistics assessment was applied. RESULTS: In 2017 to 2021, the AMP demonstrated extensive growth of the number of medicines covered, consumption volumes, and the scope of international nonproprietary names reimbursed. The pricing limits used by the AMP framework proportionally were correlated with the number of manufacturers involved. At the same time, the number of medicines containing reimbursed international nonproprietary names but not being covered by the program has been decreasing. CONCLUSIONS: The AMP framework significantly influences the pharmaceutical market and the potential to provide patients with a wider scope of essential medicines while effectively managing government and patients' healthcare spending. There is a need for the AMP re-evaluation tool enabling timely diagnosing of its shortcomings, assessing the effectiveness and helping to implement its targeted development according to pharmaceutical market tendencies and achievement of desirable patient's health outcomes.
Subject(s)
Delivery of Health Care , Prescription Drugs , Humans , Ukraine , Costs and Cost Analysis , Drug Costs , Reimbursement MechanismsABSTRACT
Open visiting policy (OVP) in intensive care units (ICU) is considered a favorable visiting regime that may benefit patients and their family members as well as medical staff. The article examines the conditions and causes of OVP-making process in Ukraine and presents the ethical analysis of its implications with respect to the key stakeholders: ICU patients, family members, and medical staff. The OVP, established by the Ministry of Health in June, 2016, changes current approaches to the recognition of the role of families in critically ill patients' care dramatically; it does, however, have serious shortcomings. The analysis of risks and benefits showed that OVP does not adequately cater to the needs of all the key players-family members, patients, and medical staff. Moreover, there is no clear mechanism to control OVP implementation via feedback from all the key players (particularly patients and their families). These issues give rise to a concern that the implementation of OVP will die on the vine. In order to prevent this, a range of measures is required: the optimization of the ICU facilities and internal procedures, supervision of OVP implementation by policy-makers, training of medical staff, and providing family members with educational programs. Considering current shortcomings, it is crucially important to develop clear and consistent internal guidelines in hospitals that will guarantee the introduction of open ICU visiting and quality of critical care provisions.
