Objectives: In Ukraine the healthcare (HC) expenditure was 6.727 USD according to World Bank data (2016). The pharmaceutical spending is screwed towards basic generics with no evidence. Only 12% of pharmaceuticals are covered by budget in Ukraine vs w74% in benchmarking EU countries and the highest share of generics in spending structure. The aim was to analyze available instruments for access to innovations to show potential tools and EU best practice for optimizing HC in Ukraine. Methods: Statistical observation method. Review existing healthcare systems in EU reference countries and comparing with current state of HC in Ukraine. Results: Ukraine has GDP per capita 9,69 USD, it's 5 times lower than in Latviab Poland (31,7USD & 33,9 USD), 8-9 times than in Czech Republic, Slovakia, Hungary (38,7USD, 36,5USD, 33,9USD, respectively). Share of state-funded medicines is 3.6% of GDP, vs 4.5% average in Eastern Europe countries. The rate of generics in HC structure was in Czech Republic 24%, Hungary 23%, Czech Republic 27%, Poland 37%, Slovakia 34% in comparison with Ukraine 75%. Despite of hurdles Ukraine has managed implemented HTA, the law regarding Managed Entry Agreements is under consideration in Parliament of Ukraine. Budgeting of HC is increasing up to 10% each year and expectantly budget for 2020 will be increased up to 30% in comparison with 2019. One more initiative of Parliament is implementation the Law on the State Financial Guarantees of Healthcare. During 2019 MoH has implemented the HTA approaches for budget procurement, but accessibility for innovations is insufficient. Conclusions: The implementation of Risk sharing agreements will allow to increase access to innovative therapies. Recommended instruments such as HTA submissions for innovation and budget procurement, pharmacoeconomic data, special budget for innovative drugs, price referencing will help to address current gaps in Ukraine HC and increase access to innovative.
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