The "Affordable Medicines" Reimbursement Program in Ukraine: Framework Assessment and Impact Evaluation

In 2017, the government of Ukraine introduced the new Affordable Medicines Program (AMP) for outpatient prescription medicines reimbursement. Despite the evident program implementation benefits, it is highly important to examine the AMP framework to reveal its current tendencies, strengths, and shortcomings that might be useful to support further development and improvement of reimbursement models. This study aimed to evaluate how the pricing strategies applied by the AMP framework might affect the potential to provide patients with affordable medicines.

The AMP framework has been evaluated by several parameters characterizing the pricing mechanisms, pharmaceutical manufacturers, the scope of medicines covered by the program, and consumption volumes. The data were collected from official government databases and open sources. The statistics assessment was applied.

In 2017 to 2021, the AMP demonstrated extensive growth of the number of medicines covered, consumption volumes, and the scope of international nonproprietary names reimbursed. The pricing limits used by the AMP framework proportionally were correlated with the number of manufacturers involved. At the same time, the number of medicines containing reimbursed international nonproprietary names but not being covered by the program has been decreasing.

The AMP framework significantly influences the pharmaceutical market and the potential to provide patients with a wider scope of essential medicines while effectively managing government and patients' healthcare spending. There is a need for the AMP re-evaluation tool enabling timely diagnosing of its shortcomings, assessing the effectiveness and helping to implement its targeted development according to pharmaceutical market tendencies and achievement of desirable patient's health outcomes.