THE STUDY OF DEVELOPMENT TRENDS OF THE PHARMACEUTICAL MARKET OF NEUROPROTECTIVE DRUGS IN UKRAINE

The main trends in development of the pharmaceutical market of drugs with the neuroprotective action in Ukraine over the past five years have been studied in the article. The analysis of indicators in sales volume of drugs with the neuroprotective action in natural units and monetary value has been also conducted. An important aspect of the work is to determine the ratio of consumption of neuroprotective drugs of domestic and foreign production within each pharmacotherapeutic group of medicines.

Statement of the problem. A rapid deve lopment of the pharmaceutical market and ap pearance of new methods and regimens of phar macotherapy on the one hand, and the growth of cerebrovascular pathology on the other hand, determine the necessity of the rational choice of drugs. Estimation of the sales leaders of drugs in each of the segments at pharmaceutical mar ket, comparison with the structure of disease prevalence in Ukraine, the standards of treatment and the information concerning their pro ven efficiency provide the possibility to esti mate the rationality of prescribing a drug under conditions of a certain nosology. Under the con ditions of limited funding of the healthcare sys tem of many countries in the world besides the rationality estimation it is important to take into consideration the economical aspects of medical technologies [2,3].
Analysis of recent research and publications. The importance of the problem of acu te cerebral vascular disease, including ische mic stroke (IS), leads to a considerable inte rest of domestic and foreign scientists to search for ways of the rational pharmacotherapy of this disease, and improve pharmaceutical pro vision of patients with IS. It should be mentioned that an important role in treatment of IS belongs to neuroprotective drugs (ND), which diminish brain damage, as well as prevent the brain necrosis after an acute ischemia [4,6].
Despite the current publications the studies of the dynamics of the ND market development have not been carried out, therefore, there is the relevance and need for further development in this direction. А. А. Kotvitska -Doctor of Pharmacy, professor, First Vice-rector for academic work of National University of Pharmacy (Kharkiv) Identification of aspects of the problem unsolved previously. Increasing the availabili ty and improving the quality of pharmaceuti cal provision relate to the priorities of the health care sector. In this regard, the recent emphasis on scientific ground, development and implementation of measures aimed at optimizing the pharmaceutical care of patients with the most common pathologies, including IS, are of interest. Among the main issues that require urgent solutions the problem of prediction of the drug use occupies a leading position. Today determination of market trends of ND is of great importance because it allows to use the objective data while taking reasonable ad ministrative and legislative solutions for improving the regulation of the pharmaceutical market of Ukraine, and also provides the efficient use of the limited resources of health and decisionmaking on investments in production.
Objective statement of the article. With the purpose of determination of features and tendencies of the Ukrainian population consumption of ND used for treating ICS the analysis of indicators in sales volume of the drugs mentioned in natural units and monetary value has been conducted.
Presentation of the main material of the research. Among factors forming the pharma ceutical market of Ukraine there are its structural changes and general dynamics (a budgetary funding dynamics of the healthcare devel-opment is especially important); the presence and implementation of the government and in ternational programs of health protection; de velopment trends in the demographic situation in Ukraine; tendencies in changing the average cost of packing drugs of domestic and foreign production; the purchasing power of the popu lation and the inflation impact on the drug sales volumes; tendencies of drug sales changes in groups [1,5].
Based on the research results the Ukrainian pharmaceutical market of ND is almost 40% dependent on foreign producers and does not provide the needs of the population as an independent state in drugs in accordance with recommendations of the Ministry of Public Health (Fig. 1). An insignificant part of domestic pro ducts also draws attention in its cost measuring at the market of ND, which is about 35% (Fig. 2). Such a tendency, in our opinion, is caused by the fact that domestic industry is concentrated on the production of drugs in the lower price assortment.
The ND market of Ukraine mostly includes 4 pharmacological groups: A -"Alimentary tract and metabolism", B -"Blood and blood forming organs", C -"Cardiovascular system", N -"Ner vous system". The research conducted showed that the Ukrainian ND market sales volume in 2014 was 1.89 billion Ukrainian Hryvnias (UAH) for 23 797 886 packages, it increased by 22.22% in monetary value compared to 2010 and significantly decreased (by 26.22%) in natural units. It should be noted that in 2014 a part of domestic drugs in the total ND sales in natu ral units decreased by 28.45% compared to 2010. The specific gravity of sales rates of import drugs for the period studied demonstrates the simi lar tendency. So, the rates mentioned decreased by 22.77%.
A different trend is observed in monetary indicators. In 20102014 the ND market in mo netary value demonstrated the increase of sa les rates of domestic drugs by 12.29%, foreign drugs -by 26.72%.
However, in spite of the gradual increase of sales rates of domestic ND, unfortunately, the pharmaceutical market remains dependent on the import.
During analysis of the pharmacotherapeutic structure of the ND consumption it has been found that the most extensive cluster is "Ner vous system", which in 2014 was 35.93% of the sales rates of the group studied in natural units, and 30.12% -in monetary value ( Table 1).
The next stage of our research was the ND sales analysis within the groups of ATCclassification.
Based on the results of the ND consump tion analysis of the pharmacotherapeutic group A it has been found that every year the sales vo lume of drugs increases. According to the results of 2014 this index was 708.42 million UAH for 4 995 891 packages with the growth rates According to the results of sales in 2014 in this segment there is increase of consumption in monetary units by 70.63% for domestic drugs and by 14.41% for import ones.
The values of the ND sales of the pharmacotherapeutic group A are illustrated in Fig. 3 and Fig. 4.
Generally, dynamics of the ND sales in the pharmacotherapeutic group A "Alimentary tract and metabolism" in natural units for all subgroups of the segment is positive. Most drugs used were vitamin B 1 in combination with vitamin B 6 and/or vitamin B 12 . Their assortment is greater in comparison with other ND subgroups. Thus, the number of the packages sold in this subgroup of drugs increased by 6.85% within the period studied.
According to the sales rates in monetary value actovegin is the leader of the given ND   It should be noted that in 20102014 at the pharmaceutical market of Ukraine the drug ran ge for actovegin and vitamin B 1 in combination with vitamin B 6 and / or vitamin B 12 formed due to import drugs.
Analysis of the ND consumption in the phar macotherapeutic group B "Blood and blood for ming organs" has shown that import drugs are not presented in the ND nomenclature at the Ukrainian pharmaceutical market (Fig. 5, Fig. 6).
It has been found that this segment is cha racterized by small sales amounts both in mo netary value and natural units compared to other ND groups.
Generally, for this group in 2014 the decrease in consumption in natural units and monetary value was observed. For example, the sales of magnesium sulphate in 2014 totaled 19.20 mil lion UAH in monetary value and 2 141 775 pa ckages in natural units, decreased by 24.31% and 23.38%, respectively, compared to 2010.
The next stage of the analysis carried out was to investigate the sales of ND in the pharmacotherapeutic group C "Cardiovascular sys tem". It has been found that domestic drugs pro vide prevailing sales in natural units in this seg ment -almost 60%. In addition, there is the increase in sales of domestic drugs in moneta ry value by 39.89% in 2014 compared to 2010. It should be noted that the increase in sales of import drugs in monetary value for 20102014 was 60.49% ( Table 2).
The analysis showed that in monetary va lue the growth rates over the period under study  Table 2). The analysis has shown that the demand for ND of the pharmacotherapeutic group C, which includes seven subgroups, for the period of 20102014 in natural units is higher in subgroups of inosine and pentoxifylline (Table 2). However, there is a negative trend of decreasing sales of inosine and pentoxifylline over this period by 50.29% and 10.96%, respectively.
Annually NDs of mildronate subgroups are characterized by the positive sales dynamics in natural units, its sales indicators in 2010 2014 increased by 1.96%.
The subgroups of nicergoline, naftidrofuryl and nimodipine are characterized by small sales amounts compared to other ND subgroups in this segment.
The leading ND of the pharmacotherapeutic group C in terms of sales in monetary value each year of the period analyzed is mildronate. Its consumption decreased by 36.87% in 2014 compared to 2010 ( Table 2).
The range of the pharmacotherapeutic group N "Nervous system" is presented by 9 INN: piracetam, citicoline, vinpocetine, cortexin, cerebrolysin, ipidacrine, choline alfoscerate, betahistine and cinnarizine. The ratio of sales of these drugs assessed in monetary and natural indicators are presented in Fig. 7 and Fig. 8, respectively.
As it is seen from these figures, the leaders in sales in monetary value are citicoline, betahistine and cerebrolysin, their proportion of mar keting is 28.35%, 15.60% and 15.12% of the total market size for ND of the pharmacothe rapeutic group N, respectively.
Demand for ND of the pharmacotherapeutic group N in natural units is higher in subgroups of piracetam (27.53%) and cinnarizine (22.93%), and it may be explained by the widest range of these drugs in Ukraine. The next stage of the analysis was to study the dynamics of sales of the most promising ND in the pharmacotherapeutic group under research. The sales indicators of these drugs in this segment are presented in Fig. 9 and Fig. 10.
According to the results of the analysis it has been determined that ND under research had rather stable sales indicators in 20102014 in both natural units and monetary value (Fig. 9,  Fig. 10). The leader of the ND segment by sales indicators both in monetary value and in natural units was citicoline, its consumption increased by 41.98% and 31.88%, respectively, in 2014 compared to 2010. It should be noted that the increase in sales rates of domestic drugs of the citicoline subgroup for the period studied in natural units was 78.11%, import drugs -2.67%. However, in monetary value the consumption of domestic drugs increased by 79.99%, while import drugs -by 25.45%.
For drugs of the cerebrolysin subgroup a po sitive trend in sales in monetary value was ob served -6.63%. At the same time the consump tion of cerebrolysin in natural units decreased by 50.63% in 2014 compared to 2010. It should be noted that in 2010 and 2014 the drug range of the cerebrolysin subgroup at the Ukrainian pharmaceutical market was formed mainly due to import drugs. It has been also found that the consumption of import drugs in this segment in monetary value for the period of 20102014 is characterized by a slight increase by 6.84%. But in natural units the consumption of import drugs decreased by 36.87%. This happened pri marily due to the expansion of the range of do Thus, these data indicate that the demand for ND of the cerebrolysin subgroup within the period studied has shown a stable dynamics, however, there is an increase in the drug consumption of the citicoline subgroup.

Conclusions
The research has shown that the volume of the Ukrainian ND market in 2014 was 1.89 bil lion UAH for 23 797 886 packages, it increased compared to 2010 by 22.22% in monetary va lue and decreased by 62.22% in natural units.
The analysis of the ND consumption of the pharmacotherapeutic group A has revealed that drug sales increase every year. According to the results of 2014 this figure was 708.42 million UAH for 4 995 891 packages with the growth rates by 24.43% in monetary value and an in significant decrease (by 4.29%) in natural units compared to 2010.
It has been found that the ND sales for the pharmacotherapeutic group B within 2014 to taled 19.20 million UAH in monetary value and 2 141 775 packages in natural units, and decreased by 24.31% and 23.38%, respectively, compared to 2010.
According to our data it has been determi ned that domestic products provide the prevailing sales in natural units -nearly 60% in the pharmacotherapeutic group C segment. In addition, there is the increase in sales of domestic drugs in monetary value by 39.89% in 2014 compared to 2010. It should be noted that the increase in sales of import drugs in mon-etary value for 20102014 was 60.49%. However, significant negative changes of the ND sa les dynamics of this group are observed. Thus, for domestic drugs there is the decrease in sales in natural units by 47.80% in 2014 compared to 2010, for foreign drugs -by 19.50%.
Ranking of ND of the pharmacotherapeutic group N presented at the pharmaceutical market of Ukraine indicates that the leaders by the sales volumes in monetary value are citicoline, betahistine and cerebrolysin subgroups, their the proportion of marketing in the total market size of this segment is 28.35%, 15.60% and 15.12%, respectively. However, the ND de mand for this group in natural units is higher in subgroups of piracetam (27.53%) and cinnarizine (22.93%), and it can be explained by the widest range of these drugs in Ukraine.