Pilot projects on pharmaceutical insurance are being launched in Rivne, Sumy, Zaporizhia, Odesa, Kharkiv, and Kyiv. The relevant memorandum for their implementation was signed at the Ministry of Health of Ukraine on December 7.
“According to the Ministry of Health, Ukrainians leave about UAH 60 billion annually in pharmacies, and more than 50% of them spend on drugs without proven effectiveness and for unreasonable purposes.
The pilot project on pharmaceutical insurance is an opportunity to reduce the financial burden on the family budget through voluntary health insurance.
“There are medicines that are not included in the” Affordable Medicines “program, and the cost of which is not reimbursed under the reimbursement program, and it is thanks to voluntary insurance that you can get compensation for medicines prescribed during outpatient treatment,” said Health Minister Viktor Lyashko.
Doctors already have access to the pharmaceutical insurance system in the urban health facilities involved in the pilot projects. In order to participate in the project, the patient must purchase an insurance policy and notify their doctor. The patient will pay UAH 120 per month and will be able to use the sum insured of UAH 20,000 if he is prescribed drugs that are not included in the “Affordable Medicines” program and the cost of which is not reimbursed under the reimbursement program.
To receive medication under insurance in case of illness, the patient comes to the doctor, is examined, receives a prescription for medication. Drugs included in the pharmaceutical insurance program are automatically booked at the pharmacy. The patient receives a message with information about the pharmacy where you can pick up the medicine. Payment for medicines by the insurance company is automatic, without the involvement of a patient or doctor.
The project is controlled, prescriptions are issued only for international non-commercial names of drugs (INN). The choice of trade name is automated and operates on the principles of affordability and price. The conditions of the project make it impossible to prescribe drugs that are not provided for in clinical protocols.
To implement this project, the Ministry of Health, the Verkhovna Rada Committee on Nation Health, Medical Care and Health Insurance, the National Association of Insurers of Ukraine, the League of Insurance Organizations of Ukraine, the Insurance Business Association, and JSC PrivatBank concluded a memorandum of cooperation in the field of voluntary health insurance of expenditures related to the provision of medicines and medical devices.
A working group is currently being formed to work out issues and solutions that may arise during the project implementation.
The memorandum has an open form – it can be joined by other participants who are ready to develop medical services in Ukraine.
For reference: Since October 1, the Affordable Care Act has expanded to include 466 drugs for the treatment of cardiovascular disease, diabetes, prevention of stroke and heart attack, bronchial asthma, epilepsy, mental and behavioral disorders. This year, the Affordable Care Act has already reimbursed UAH 963 million for repaid prescriptions.