The Ministry of Healthcare of Ukraine continues a fundamental transformation of the national healthcare system. The fight against corruption is one of the top priorities, therefore the Ministry’s key goal is to establish clear and transparent rules to eliminate corrupt practices in the Ukrainian health sector.
Currently, the Ministry implements the following seven strategic programs, which are aimed not only at achieving progress in the relevant areas of focus, but also at creating transparency and openness to eliminate corruption-generating practices and schemes.
The Ministry of Healthcare of Ukraine has been cooperating with specialized international organizations and agencies in public procurement since 2016. This program has proved to be efficient, including by providing more Ukrainians with high quality medicines – transparent tender procedures and direct purchases allowed purchasing twice as many medicines for certain government programs with the same amount of money as paid in previous years. For example, international organizations procured Imatinib – a medication used to treat cancer - at 67 times lower prices, which allowed the Ministry to cover 100% of the blood cancer patients’ demand in this medication.
The procurement of heart stents is another example. For the first time ever, Ukraine procures heart stents to cover the estimated average annual demand in stents, calculated based on the average annual number of myocardial infarction patients who need emergency stenting. In emergency cases, stent placement is to be performed free of charge.
The procurement reform provides for the development of international cooperation with independent organizations in the strategic procurement of medicines and healthcare products. Open and transparent tenders allow cutting out the crooked insiders inflating prices for their own benefit.
Based on the World Health Organization (WHO) Model List of Essential Medicines, the Ministry of Healthcare of Ukraine has developed the National List of Essential Medicines (NLEM). The current NLEM includes 427 INNs, selected with due regard to disease prevalence, efficacy, safety and cost effectiveness. Today, health facilities nationwide have to procure the medicines included in the NLEM to satisfy 100% of the priority health care needs of the population. These medicines are to be provided to patients free of charge. Taxpayers’ money is no longer spent on wild carrot extracts or extracts from the bulls’ blood.
To ensure open access to information about the medicines that are to be provided to patients free of charge, the Ministry of Healthcare of Ukraine issued a special order stipulating that every week all health facilities and departments across the country have to report on the availability of these medicines in stock. The information is to be updated on the official websites and to be posted on bulletin boards within hospitals and health facilities. In addition, the Ministry is currently developing a single electronic system to regularly collect and update actual information on the availability in stock of medicines and healthcare products to make this information more easily accessible to every citizen of Ukraine.
The Ministry has also launched the Ye Liky website and the Liky Control mobile application, which allow patients to check whether certain medicines are included in the state-guaranteed NEML, available in stock at a particular health facility, and are to be provided free of charge.
Every medical institutions and health facility has to publish information on any voluntary payments and contributions from patients and their families. This information is to be posted on bulletin boards within hospitals and health facilities, or published on the official websites.
In the first year since the program launch in April 2017, Ukrainians made 17,000 less ambulance calls in the event of suspected stroke or heart attack, or in case of asthma attacks.
Today, the program provides free medicines to people who used to choose between buying foods and buying medicines. More than 6 million Ukrainians have already started using the program.
Currently, the program includes 261 medicines, 59 of which are provided 100% free of charge with proper prescription.
In 2018, a fundamental transformation of the healthcare financing model has begun in Ukraine. It provides for the introduction of a modern capitation model, starting in primary care, with strategic purchasing of services based on relevant output indicators gradually replacing the outdated system of input-based financing.
In July 2018, the National Health Service of Ukraine (NHSU) started paying the contracted PHC providers an age-adjusted capitation per declaration at a rate, which is significantly higher than in traditional funding model (healthcare subventions from the state budget funds).
Patients can now freely choose own family doctors, general practitioners, or pediatricians, and have unrestricted access to all primary care services included in a clearly defined, state guaranteed benefit package. The introduction of the benefit package covered by the NHSU ensures transparency and clarity for patients, while the autonomy and independent management of health facilities provides for fair remuneration of work, i.e. an increase in salaries of health professionals and medical staff.
It is a reliable instrument that forms the foundation for the development of transparent funding mechanisms to ensure timely reporting on the use of public funds, the collection of accurate statistics, and the protection of personal data of patients.