Every other patient in Ukraine refuses from treatment or postpones it because of money shortages. High cost of medications is considered by 94% 0f patients involved in the focus-group discussions as the major problem. In this case 48% of patients complain about adulterated and low-quality medicines. Almost 70% of the patients resort to self-treatment. These are the findings of the research conducted as part of the USAID-funded “Cost(less) Medicine” project implemented by the CF “Patients of Ukraine”.
“Free health care in Ukraine is a myth. In fact, every patient pays twice – in the form of tax and at the doctors’ office. Health care should be free and accessible all at once. Meanwhile Ukrainians have to refuse from treatment or postpone it or use medicines they learn about from their friends or from the Internet. Often Ukrainian patients are unaware of the free public programs and about opportunities to get free medicines,” reported Olga Stefanyshyna, Executive Director of the CF “Patients of Ukraine”.
The research findings show that over 56% of patients used only part of the prescribed medicines because of financial constrains. 43% of patients had to borrow money or to sell valuables and property for treatment. These data along with the conclusions and recommendations of the CF “Patients of Ukraine” were provided to the MoH Ukraine in order to improve implementation of the ongoing health reforms.
“Health care services in Ukraine should be quality and accessible for every patient and we put every effort to get the health reform up and running this year. Hopefully, the Law “On State Financial Guarantees for Providing Health Care Services and Medicines” will be adopted by May this year. In addition, the Pharmaceutical Reimbursement Program is expected to start working in pharmacies since April 2017. The government will allocate UAH 500 million for its implementation. The Unified E–Database of Patients will have to work by the end of the year”, reported Uliana Suprun, acting Health Minister of Ukraine.
The research also reports that almost 69% of patients treat themselves without consulting doctors. The reasons are high cost of medicines, lack of trust in doctors as well as poor treatment culture of Ukrainians. Fifty percent of all Ukrainians used medicines recommended by their friends and the Internet.
“This research is designed not only to expose the problems of the Ukrainian patients but also to equip the Government of Ukraine with the data. Its findings are intended to inform, develop, and implement the health reforms targeted at solving the problems of individual patients and thus the nation as a whole. The health care reform is the priority for Ukraine”, reported Susan K. Fritz, the USAID Mission Director for Ukraine, Belarus and Moldova.
Ukrainians do not trust in doctors. Almost 40% of focus group participants complained about non-professionalism of the medical staff. Generally it is about incompetence and indifference of the doctors, that they often do not ask a patient about his/her condition and provide no or very little information about their prescriptions. Doctors in roughly half the instances propose cheaper and more expensive medicines as an option. One third of the patients admit that doctors prescribe too many drug items. Corruption in health facilities is also viewed by the patients as the reason for mistrust.
Analysis of the top-100 most salable medicines in the Ukrainian pharmacies showed that patients spend more than UAH 3 billion every year for the medicines they may well do without.
Therefore, in order to start treatment the patients have to use various strategies – postpone treatment, pass incomplete treatment course, borrow money and sell property. This confirms inconsistency of the pharmaceutical policy in Ukraine: it is a patient who shares the bulk of the financial burden.
The research was conducted in April – September 2016 by using the following methodologies: desk, qualitative (in-depth interviews with the patients and doctors, focus-groups) and quantitative (Omnibus) research. The Health School NAUKMA and Kiev International Institute of Sociology provided expert support of the research.
Research “Cost(less) Medicine” is available at the website of the CF “Patients of Ukraine” in pdf format.
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