УДК 338.5:615.252.349.7

Increasing the availability and affordability of medical and pharmaceuticalcare to the population is the most important task of all levels of government. The purpose of the work is to study the affordability of glucose-lowering drugs for the treatment of type 2 diabetes in Ukraine. Research materials are: State
Register of Medicinal Products and price of glucose-lowering drugs. Marketing, analytical, graphic and pharmacoeconomic analysis were used. On the pharmaceutical market of Ukraine 161 glucose-lowering drugs are registered, which contain 16 international non-proprietary names and 8 international non-proprietary names combinations. It was established that the cost of Defined Daily Dose for mono glucose-lowering drugs varies from UAH 1,1 for glibenclamide up to UAH 90,7 for liraglutide. Most of the Ukrainian-made and foreign drugs are highly affordable, but foreign preparations of modern groups are moderately affordable, only one foreign drug, Liraglutide, is unaffordable ratio. But the analysis of affovailability for pensioners only metformin (Ukrainian production), glibenclamide, gliclazide, and glimepiride are highly affordable, three of which are already subject to reimbursement. Modern glucose-lowering drugs, both of foreign and Ukrainian production, is scarcely affordable, which makes it practically impossible to use them in the majority of retirees with diabetes. Thus, the analysis showed that in order to implement modern treatment schemes for type 2 diabetes, which according to the current
legislation can be used in Ukraine, it is necessary to expand the list of glucose-lowering drugs included in the reimbursement program. This will improve treatment results, which in turn will reduce the development of diabetes complications and improve the quality of life of patients.  

Purpose: Diabetes care, particularly type 2 diabetes (T2D), is recognised as a growing challenge in emergency situations. During the humanitarian crisis of war in Ukraine, it is important to focus on ensuring that patients have access to essential medicines for T2D. Since 1 April 2017, the Ministry of Health of Ukraine has been implementing the government programme "Aordable medicines". e List of reimbursed medicines necessary for the treatment of hypertension, diabetes and bronchial asthma includes 3 glucose lowering medicines (GLMs) - gliclazide, metformin, glibenclamide. From 01 April 2019, electronic prescribing has been implemented as part of the "Aordable Medicines" programme. It is important to investigate changes in the availability and aordability of GLMs for the treatment of T2D during the war and future directions in 2022-2023 in Ukraine.
Methods: Information from the State Register of Medicinal Products of the Ministry of Health of Ukraine from March 2023 and February 2022 (before the start of the war) was the subject of the study. Marketing, analytical, graphical, generalisation analyses were applied. Analysis of the cost of 1 DDD GLM according to the WHO ATC/DDD index and solvency ratio analysis were applied.
Results: is study is based on actual data from before the war in Ukraine and now shows that the aordability and
availability of GLMs during the war in 2022-2023 has not changed dramatically. e 'Aordable Medicines' program
was stably implemented, with €111.9 million allocated in 2023 and within 6 months of 2023. e National Health
Service of Ukraine reimbursed €42.8 million to pharmacies for the Reimbursement List. Most Ukrainian manufacturers and foreign GLMs are very aordable due to the reimbursement system. From October 2023, 23 names of test stripes were included in the Reimbursement list of the "Aordable medicines" programme. However, foreign GLMs of innovative groups are moderately aordable for the working population based on the calculated solvency ratio.