How to get free medications?

Step-by-step instruction:

Get an appointment with the doctor (therapeutist, pediatrician or family doctor) with whom you signed a patient declaration form, and get an electronic prescription (e-prescription).
Go to a pharmacy with a sign “We have Accessible medications”.
Get your medications for free or for a partial price according to your e-prescription.

The price for the medications will be entirely or partially paid by the state. Only mono-
drugs (those that have only one active ingredient) are participating in the Program.

How to get an electronic prescription for “Accessible medications”?

From April 1st , 2019 you can get medications in the Program “Accessible medications”
only on the basis of the electronic prescription given by family doctor, therapeutist or
pediatrician through the electronic system of healthcare.

Step 1. The patient should get an appointment and visit a family doctor, therapeutist or
pediatrician, with whom he signed a patient declaration form.

Important! The patient shall have an appointment exclusively with his doctor. If you
didn’t sign the patient declaration form yet, you should do it. You cannot use the
Program “Accessible medications” without the declaration form.

Upon that, if the patient has a chronic or lingering illness, or needs to continue the
treatment of previously-diagnosed disease according to an established scheme, he can
contact the doctor by telecommunication methods (telephone, e-mail, messengers –
depending on which method of communication was agreed with the doctor) and the
doctor has the right to give the prescription without having an appointment with the
patient.

Step 2. The doctor attends the patient and makes an e-prescription.

Step 3. When giving an e-prescription, the doctor together with the patient have to
check if the mobile phone number stated in in the patient declaration form is correct

and belongs to the patient. The doctor shall give you a mobile operator code and the
last number digits. In case the phone number does not belong to the patient or it has
been changed, the information about the phone number must be renewed. You can
change the phone number through the electronic form on the website of NHSU in the
section “For citizens”. The request can be submitted by the patient himself or by his
doctor upon the patient’s request. More details on changing the phone number you
can find here.

Step 4. After verifying the phone number, the doctor gives to the patient the electronic
prescription in the electronic health care system.

Step 5. The patient receives a message on his phone with the unique number of the
prescription and the confirmation code in order to receive his medications in the
pharmacy.

Content of the message: “Your prescription ХХХХ-ХХХХ-ХХХХ-ХХХХ. Confirmation code:
XXXX”.

To the patients who don’t use the phone and whose declaration forms have been
created without the phone number, the doctor will give a printed version of e-
prescription as an information card. It will contain the number of the prescription and
the confirmation code, as well as the information on prescribed medications and
method of their administration.

For the patients, who have got the message on their phones, the doctor can also print
the e-prescription as an information card upon their request.

Step 6. The patient goes to any pharmacy which takes part in the Program “Accessible
medications” convenient for him. There is a list of the pharmacies supporting the
Program on the NHSU website.

Step 7. In the pharmacy the patient communicates the unique prescription number
with 16 digits to the pharmacy worker in any available manner: he can tell it to the
worker, give him printed information card or a note with the written prescription
number, show the message on the phone screen, etc.

Step 8. The pharmacist offers to the patient available medications to choose from:
primarily free ones and then with partial payment.

Step 9. Next, the patient should make sure:

if medication of the particular tradename and manufacturer that he would prefer to get is available in the pharmacy?
if the amount of medication is offered in sufficient quantity?
if there will be a partial payment for the chosen medication and how much?
if so, does he agree to pay extra?

Important! If the answer to one of the questions listed above is “no”, then the patient
must not tell or show the 4 digits of confirmation code to the pharmacist.

Step 10. If the patient is okay with that, then he tells the confirmation code to the
pharmacist and makes a payment in case needed, and the pharmacist signs the
prescription with electronic signature. That is all, the prescription is settled. After that
the patient gets his prescribed medications.

If there is no particular medication in the pharmacy, that the patient wishes to get, he
should not tell the prescription confirmation code, and then he can go and check
another pharmacy. Or to order the medication which has not been available in the
pharmacy when the patient has requested.

The residents of the temporary occupied areas of Ukraine can also use the Program
“Accessible medications”: https://bit.ly/2z2GeMj

Why these categories of diseases?

The mechanism of the reimbursement of medications spreads over cardiovascular
diseases, in particular with primary and secondary prophylaxis of infarcts and strokes,
diabetes type II and bronchial asthma.

These very diseases are affecting the death rates of the population the most or
significantly decreasing the quality of life of the patients but can be effectively treated
on outpatient basis.

Mortality of cardiovascular diseases adds up to 65% of total mortality of the population
in Ukraine. According to the statistics a million of people suffers from diabetes type II.
This is 6 times more than the amount of people suffering from diabetes type I (insulin
dependent). There are over 210 thousand of people registered suffering from bronchial
asthma. Mostly, they are children are young people.

Which active ingredients are included in the Program?

Cardiovascular diseases:

Amiodarone
Amlodipine
Atenolol
Acetylsalicylic acid
Bisoprolol
Warfarin
Verapamil
Hydrochlorothiazide
Digoxin
Enalapril
Isosorbide dinitrate
Carvedilol
Clopidogrel
Losartan
Metoprolol
Glyceryl trinitrate
Nifedipine
Simvastatin
Spironolactone
Furosemide

Bronchial asthma:

Beclometasone
Budesonide
Salbutamol

Diabetes type II:

Metformin
Gliclazide
Glibenclamide

What to do if free or reimbursed medications are finished in the pharmacy?

The patient can wait until they will be available in the pharmacy again.
The patient can try another pharmacy.
The patient can choose another trademark and cover the price difference.

Which medications the patient can get for free and for which he needs to pay partial
price?

The registry of wholesale and retail prices determines the ceiling price of the
medication which can participate in the Program “Accessible medications”.

The state reimburses the cheapest medication which applied to participate in the
Program “Accessible medications”. That means that this medication the patient can get
for free.

A more expensive medication, the price of which does not exceed border line price, the
patient can get by paying the difference between minimal and retail price of this
medication.

The medications, the price of which exceeds the border line price in five neighboring
countries, don’t undergo the program of reimbursement. As well the availability of
medications depends on the manufacturers who decide whether to participate in the
Program, as they have to apply for the medication to be included in the registry.

Renewed registry of medications of the Program “Accessible medications”

On August 11, 2021 the Registry of medications which are subject to reimbursement as
of August 5, 2021 took effect, that was ratified by executive order №1705 of the
Ministry of Health of Ukraine on August 10, 2021.

292 medications were included into the renewed Registry out of which 16 from
bronchial asthma, 51 from diabetes type II, 27 for primary and secondary prophylaxis
of infarcts and strokes, 198 from cardiovascular diseases.

Out of 292 medications 70 are free for patients, and the rest the patients can get with a
small additional payment. The cheapest medication that is reimbursed by the state in
full amount costs 6.28 hryvnias, while the most expensive one costs 548.19 hryvnias.

There is a myth that only the cheapest medications of local manufacture are
participating in the Program “Accessible medications”. This is not true. In the new
Registry about a half of the medications are of foreign manufacture, that is 119
tradenames of drugs. 23 medications out of 70 that are entirely free are of foreign
manufacture.

The full list of free medications you can find here.

How to get free medications?