Organizational, legal, medical and pharmaceutical approaches to optimization of medicines’ circulation for hypertonia treatment in countryside areas

Анотація

Introduction. Parliaments of both Ukraine and the EU have ratified Association Agreement (hereinafter – Agreement), a comprehensive document which envisages bringing all areas of the law of our country in line with European Union norms. Therefore, chapter 22 of the Agreement "Public Health" gave attention as one of the most important areas of implementation. That is, the need for introduction in Ukraine of the approach, called "Health in all policy areas” provides consider of the interests of public healthcare in approving of political solutions in any area of the state activities. The organizational, medical and pharmaceutical approaches to optimization of the medicines’ circulation is the improvement of the legal system of regulation of prescription and OTC medicines (drugs), determination of the circulation of drugs of different classification and legal groups, assigning drugs to one of nomenclature and legal groups (prescription or non-prescription).Materials and methods. Forensic and pharmaceutical researches conducted in countryside areas at the regional level on example of the Kharkiv region based on 54 communal health institutions (CHI). Materials of the research: legal framework for the organization of pharmacy of the CHI; forensic and pharmaceutical practice for the period of 2012-2015 concerning the provision with the medicines of all legal, nomenclature and classification groups for the pharmacotherapy of hypertension in the village. In conducting the research, we used the following methods: legal, documentary, comparative analysis, forensic and pharmaceutical monitoring.Results and discussion. According to the Statement of the Cabinet of Ministers of Ukraine from 17.08.1998 N1303 was sorted the procedure of the concessional dispensing of the drugs (for free or at 50% discount). The procedure applies to certain categories of the population and some diseases for which benefits established by applicable law. Despite the potential of this mechanism, it does not work within the budget funding. Thanks to the work of the Department on the final stage of the pilot project during the circulation of drugs and their reimbursement attracted 575 pharmacies of different ownership forms and 1253 pharmacy points, whose work is in the village carried out by medical points, general practice and family medicine. The conducted monitoring shows us that during the pilot project 72 doctors of the CHI issued more than 265.2 thousand recipes. Hypertension drugs at discount prices began to sell from pharmacies of Ukraine from 01.08.2012. Drugs released by prescription, which could only write some doctors, family doctor, cardiologist, internist and neurologist. To control this process created a single electronic register of doctors and patients. Reimbursement cost of drugs for the treatment of essential hypertension conducted from the state budget. During the implementation of these measures was made following. Order from 23.05.2012 N331 "On creation of working groups” Department organized a telephone hotline (057)705-10-64 for providing citizens, patients, most doctors, physicians, pharmacists and others with advices on the introduction and implementation of pilot projects involving scientific department of medical and pharmaceutical law, general and clinical pharmacy of the Kharkiv Medical Academy of Postgraduate Education. Order of the Department of Healthcare of Kharkiv Regional State Administration from 10.09.2014 N560 "On approval of the register of pharmacies" approved list of pharmacies and their departments participating in the pilot project, which has 576 outlets realization of drugs.Conclusions. Proposed the organizational, legal, medical and pharmaceutical approaches to optimization of medicines’ circulation for the treatment of hypertonia in countryside areas. Studied the existing legislative and regulatory framework of Ukraine on providing ofor concessional patients with hypertension drugs. Analyzed forensic and pharmaceutical risks that cause problems in access for the patients to needed medicines. Studied the example of forensic and pharmaceutical practice of imperfections in pilot project among the countryside population. Studied the system of interaction between specialists of medicine, pharmacy, state government and other industries in the area of public access to essential medicines. A review of the pilot project of reimbursement of the cost of antihypertensive medications features in the Kharkiv region, the consequences of this project for patients and healthcare of Ukraine and Kharkiv region.