The prevalence of infertility has risen 2.9 times in recent years in Ukraine. The use of assisted reproductive technologies (ART) is needed. The State program for infertility treatment by budget funds was approved in Ukraine since 2004. However, funding for this program is enough only for 500–600 cycles per year, but ART centers conducted more than 27,000 cycles in 2018. This means that many women have to pay out-of-pockets. Our research has shown that between 2000 and 2018, the number of ART clinics and the number of cycles, pregnancies, and children born increased significantly in Ukraine. The rate of ART cycles per 1 million population in Ukraine has increased from 226.9 to 655.3, but it is lower than the WHO recommended rate 800–1000 cycles per 1 million population. Changes in the structure of ART cycles for 2000–2018, the increase of ICSI, and egg donation cycles are shown. It requires an adequate supply by hormonal drugs for ovarian stimulation in ART centers. Since 2004 Ministry of Health of Ukraine annually approved the list of medicines for State program of ART. Only 8 drugs were purchased by the state funds, which amounted for USD 227 438 in 2017, 2018. A retrospective analysis of drug prescriptions in short and long stimulation protocols was performed. The frequency of drug prescriptions according to the ATC-classification based on medical records was determined, all prescriptions were accordance with the requirements of ART treatment standards in Ukraine. The costs of the three hormonal stimulation schemes, which were the most prescribing in ART center, were calculated. It was found that costs for hormonal schemes increased by 22–54% during 2015–2020, it significantly reduces the availability and affordability of ART for the population in Ukraine.
Ukraine has launched a government program «Affordable Medicines» for patients with cardiovascular disease, type 2 diabetes and bronchial asthma in 2017, which reimburses essential medicines for outpatients. Since April 2019, electronic prescriptions for the «Affordable Medicines» program have been introduced. The purpose of this study was to analyze and compare the development of a government drug reimbursement program, including the dynamics of the number of prescription and dispensed electronic prescriptions for medicinal products in the «Affordable Medicines» program in 2019, both in Ukraine and at the level of Lviv city and Lviv region. For research and analysis, we have obtained statistics from the National Health Service of Ukraine (NHSU) on the number of e-prescriptions for medicines in the Affordable Medicines program and pharmacy facilities involved in the program over certain periods from April to December 2019 across Ukraine and at the level of Lviv city and Lviv region. We used informative, comparative research methods and a method of retrospective analysis of the dynamics of prescribed and dispensed e-prescriptions for medicines. The results of the study showed that Lviv region is consistently among the leaders of e-dispensing medicines. E-prescriptions are most commonly prescribed for patients aged over 65 years old with cardiovascular disease. Differences in e-appointments of pharmacies by INN at the level of Lviv city and Lviv region are revealed in comparison with the average data of Ukraine. E-prescribing has been shown to increase access to medication for patients, as at the end of 2019 through the «Affordable Medicines» program, 1.77 million patients were enrolled and 10.86 million e-prescriptions were written out, of which 9.23 million (84.94%) were released from pharmacies. Lviv region has actively implemented e-prescriptions and according to the NHSU 43% of the pharmacies in the region are connected to this system and they issue e-prescriptions, that is higher than the average data in Ukraine of 35%. The positive dynamics of the growth of e-prescriptions written and released of essential drugs from 29% to 85% indicates the effective implementation of the e-prescription in Ukraine and confirms the effective implementation of the drug reimbursement program. Considering the benefits of electronic prescriptions, reducing the number of errors, time, monitoring appointments, it is promising to expand the list of drugs, including. those that are purchased for budgetary or accounting purposes to optimize pharmaceutical assistance to the public.
The cost analysis for the relief of migraine attack using selective 5HT1-receptor agonists (frovatriptan, zolmitriptan, risatriptan, sumatriptan) of domestic and imported manufacturers in various dosages and forms of production in the proposed resource online pharmacy chains of Lviv for their efficient and cost effective applications. Among the registered drugs, most dosage forms and trade names are presented for sumatriptan; slightly less for risatriptan and zolmitriptan; for frovatriptan is only one trade name. It has been found that to relieve migraine attack with domestic drugs will be cheaper for patients than imported. Packaging with the same dosage of active ingredient, but with more tablets in the blister is more cost effective for patients. It`s the most economical to stop the migraine attack with Stopmigren (sumatriptan) at a dosage of 50 mg, packing 6 tablets in a blister, and the most valuable drug is Rapimig (zolmitriptan) at a dosage of 50 mg, packing 6 tablets in a blister.
<p><strong>INFORMATIONAL-ORGANIZATIONAL PROVIDING OF PHARMACEUTICAL CARE FOR PATIENTS WITH EPILEPSY</strong></p><p><strong>Y.O.Hrynkiv, O.B.Blavatska, M.O. Lozynska</strong></p><p>Danylo Galytskyj Lviv National Medical University, Lviv</p><p><strong>Summary:</strong> The analysis of information on antiepileptic medicines (AEM) in standardized clinical protocols of medical care for patients with epilepsy, State Medicinal Formulary (SMF) of Ukraine 6th and draft 7th editions and comparison of information about AEM in these sources with the State Register of Medicines. It was found that currently registered AEM arsenal (14 INN) is mentioned in the main text of these sources of information and standardized clinical protocols of primary, emergency, secondary and tertiary medical care for patients with epilepsy.</p><p><strong>Keywords:</strong> Antiepileptic Medicines (AEM), State Medicinal Formulary (SMF), State Register of Medicines (SRM).</p><p><strong>Introduction.</strong> About 50 million people worldwide have epilepsy, nearly 80% of them live in developing countries. Epilepsy responds the treatment about 70% of cases, yet about three fourths of affected people in developing countries do not get the treatment they need. Epilepsy and epileptic syndromes is one of the most widespread and socially significant diseases of the nervous system. The prevalence of epilepsy in the general population in most European countries is 80-230 cases per 100 thousand people. In Ukraine in average of 50-73 persons per 100 thousand suffer from it. According to majority epidemiological studies conducted in our country and abroad, today an increase of the part of epilepsy in the general structure of nervous system diseases from 0.5 to 0.8-1.2%.</p><p>The purpose of this study is to analyze standardized clinical protocols of medical care for patients with epilepsy (Ministry of Health of Ukraine order № 276 from 17.04.2014), State Formulary of Ukraine 6th edition (approved by the Ministry of Health of Ukraine order № 252 from 08.04.2014), draft of 7th edition of the State Formulary, and compare information about AEM in these sources with the State Register of medicines of Ukraine.</p><p><strong>Methods.</strong> To achieve the goals and objectives methods of information retrieval, comparative analysis, synthesis, system, target-oriented were used.</p><p><strong>Results and discussion</strong>. By the latest official data of Ministry of Health (2012) there are about 100,000 patients with epilepsy in Ukraine, but this figure taking into account the statistical average of global prevalence of the disease, most likely is understated. In connection with the providing of medical care for patients with epilepsy by neurologists and psychiatrists, respectively, due to the double coding and registration of clinical expertise and epidemiology, statistics data are fundamentally incorrect and need a new regulation.</p><p>According to the analyzed sources one can say that standardized clinical protocol of primary, emergency, secondary (specialized) and tertiary (highpecialized) medical care "Epilepsy in Adults" contains the largest number of AEM, which can be used, but not all of them are registered in Ukraine and exist in State Formulary. Eslikarbazepin (registered in Ukraine under the brand name "Eksaliyef" from July 2012.) is the only currently registered in Ukraine AEM not included in the list of medicines that can be purchased with state funds.</p><p>Almost all of these medicines are prescribed on the ordinary prescription forms F-1 and do not stand in the subject-quantifiable accounting (except phenobarbital: the F-3 form, SQA), which increases the physical availability of antiepileptic drugs.</p><p><strong>Conclusions.</strong> Arsenal of AEM currently registered in Ukraine generally corresponds with the standardized clinical protocol of primary, emergency, secondary (specialized) and tertiary (highspecialized) medical care for patients with epilepsy; adopted Clinical guideline on epilepsy and State Formulary 6th edition. 93% AEM, which are currently registered in Ukraine can be purchased by public funds, which gives patients the opportunity to receive adequate and appropriate treatment.</p>
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