Social Pharmacy in Health Care

Decision-making in the health technology assessment system: basic approaches, criteria, and conditions

V. M. Nazarkina — 2025-09-04

The development of the health technology assessment in Ukraine involves not only its wider implementation in medical and pharmaceutical practice, but also the mandatory use of its results to substantiate decisions on the rational use of medicines and cost optimization.

Aim. To study the peculiarities of organizing expert and advisory processes in the system of the health technology assessment, in particular, methodological approaches, criteria, and conditions for decision-making based on it.

Materials and methods. Using a systematic approach, the analysis, generalization and systematization of data from scientific publications, analytical and reporting documents were carried out. A survey of medical and pharmaceutical workers was conducted on the use of results of the health technology assessment in practical activities.

Results and discussion. The analysis shows significant differences in the organization of the health technology assessment and critical evaluation of its results (appraisal) for decision-making based on it. A survey of physicians and pharmacists revealed the main approaches, criteria, and conditions for evidence-based decision-making and their information support. The survey results indicate the insufficient use of the health technology assessment results in practice due to lack of time, inaccessibility of resources, and the absence of relevant knowledge and skills. Respondents are guided primarily by regulatory documents (protocols, guidelines, forms), relying on their own experience and the expert opinion. At the same time, specialists are aware of the importance of assessment for selecting optimal health technologies and improving the efficiency of medical and pharmaceutical care.

Conclusions. The development of theoretical and methodological approaches to the organization of expert and advisory processes, the involvement of stakeholders, the use of information sources, analytical tools for their critical assessment, and processing tools is an important step in the implementation of the health technology assessment at various levels of management.

Formation of the organizational and legal mechanism for ensuring gender equality in the pharmaceutical sector of the healthcare system of Ukraine

N. M. Sakhnatska — 2025-09-04

In the context of reforming the healthcare system of Ukraine, it is particularly important to modernize gender-sensitive personnel policies, which are part of the socially responsible management paradigm. The pharmaceutical industry in Ukraine is highly feminized, but there are still barriers to protecting women’s labor rights, ensuring equal access to managerial decision-making, fair remuneration, opportunities for professional growth and a balanced distribution of working hours and rest. This determines the urgency of the problem and the need for its thorough scientific understanding.

Aim. To substantiate the need to form an organizational and legal mechanism for ensuring gender equality in the pharmaceutical sector of Ukraine, taking into account the national legislation, international experience and current challenges related to the transformation of the healthcare system under martial law.

Materials and methods. The research materials were normative legal acts in the field of healthcare and pharmacy, scientific publications by domestic and foreign authors, non-financial reports of leading global pharmaceutical companies, as well as information resources from the official websites of public professional associations. The following methods were used in the course of the work: the content analysis of regulatory and legal acts, scientific publications and non-financial reports, a systematic approach, a structural-logical method, methods of comparison and generalization, as well as a graphical method for visualizing the research results.

Results and discussion. It has been found that despite the existence of legislative guarantees of gender equality, Ukraine lacks a systemic mechanism for implementing a gender-sensitive approach in the management of pharmaceutical organizations. The experience of leading pharmaceutical companies, including practices of gender-sensitive human resource policies, mentoring programs, and initiatives to reduce the gender pay gap, has been summarized. Based on the systematization of the data, a multi-level model for implementing gender equality principles at the macro-, meso-, and micro-levels has been proposed.

Conclusions. The results of the analysis confirm the prospect of forming a comprehensive organizational and legal mechanism for ensuring gender equality as a necessary condition for the sustainable development of the pharmaceutical sector in Ukraine. The integration of the gender approach will contribute to improving the efficiency, innovation and sustainability of the industry in the context of the European integration and post-war reconstruction. The multi-level model proposed for implementing the gender policy – at the macro, meso and micro levels – is of great practical importance as it provides a comprehensive approach to eliminating gender disparities, strengthening human resources and institutional capacity of pharmaceutical organizations.

Prospective pharmaceutical counseling in the treatment of patients with anxiety and depressive disorders

K. S. Hoshtynar — 2025-09-04

The increasing prevalence of anxiety–depressive disorders has led to a growing use of antidepressants, and is accompanied by an elevated risk of polypharmacy and drug-related problems, especially in patients with chronic somatic diseases. In this context, prospective pharmaceutical counseling is a critical tool to improve the safety of pharmacotherapy, prevent potential drug–drug interactions, and enable individualized treatment.

Aim. To develop an algorithm for minimizing the risk of drug-related problems when prescribing antidepressants to patients with anxiety–depressive disorders by introducing prospective pharmaceutical counseling.

Materials and methods. As part of the study, a questionnaire was developed to identify potential drug-related problems when prescribing antidepressants to patients with anxiety–depressive disorders. The questionnaire, which was filled out by psychiatrists during outpatient consultations, included data on comorbidities, concomitant medications, dietary supplements, and lifestyle factors. Based on the completed questionnaires, and without access to patients’ personal data, the pharmacist performed a real-time risk assessment of drug-related problems and provided recommendations for optimizing the pharmacotherapy.

Results and discussion. The analysis of the survey revealed a high prevalence of comorbid conditions and polypharmacy among patients receiving antidepressants: 76 % had comorbidities, and 24 % were prescribed five or more medications concurrently. The most frequent drug-related problems were potential pharmacokinetic interactions, accounting for 71.1 % of all identified cases. A statistically significant correlation was found between the patient age, the number of prescribed drugs, and the number of drug-related problems identified. An algorithm for assessing and minimizing the risk of drug-related problems was developed and proposed.

Conclusions. Prospective pharmaceutical counseling based on the questionnaire data has enabled the structured identification of potential drug-related problems and the development of clinically oriented practical recommendations. The results obtained confirm the feasibility of integrating pharmacists into a multidisciplinary team when prescribing antidepressants.

Formation of ethical competencies of future pharmacists: analysis of labor market requirements and educational programs

N. A. Sushcuk — 2025-09-04

Modern pharmaceutical practice requires not only profound knowledge of professional disciplines but also a high level of ethical responsibility. An important indicator of the quality of work of a modern pharmaceutical professional is adherence to the principles of pharmaceutical ethics and deontology, which encompasses a high level of personal culture, professional awareness, and tact in relation to the consumer.

Aim. To identify the ethical competence requirements set by stakeholders for students and study approaches to the formation of the necessary competencies of future pharmacists.

Materials and methods. The theoretical and methodological basis of the study consisted of modern concepts of teaching the educational component (EC) “Ethics and Deontology in Pharmacy,” as well as the current regulatory and legal framework in the field of higher education and pharmaceutical practice. The information base of the research was the author’s own studies, scientific publications related to the issues of ethical training of pharmaceutical specialists, as well as educational and professional programs and methodological materials of higher education institutions (HEIs) of Ukraine training Masters in the specialty “Pharmacy, Industrial Pharmacy”. During the study such methods as the content analysis, system-analytical, logical analysis, and generalization, were used.

Results and discussion. It has been found that 70% of the pharmacy chains analyzed included specific ethical competence requirements in their job postings for pharmaceutical specialists. Ethical competencies occupy a central role in pharmaceutical practice, which is confirmed by stakeholder expectations toward the future personnel. An analysis of the approaches to forming the necessary competencies in future pharmacists when teaching the EC “Ethics and Deontology in Pharmacy” in HEIs that train specialists of the second (Master’s) level in specialty I8 “Pharmacy (by specializations)” indicates that the educational and professional program correlates with the stakeholder requirements for staff recruitment.

Conclusions. The research conducted indicates the importance of teaching this EC in the training of specialists in the field of I8 “Pharmacy (by specializations)”.

A comparative analysis of the consumption of medicines from the group of calcium channel blockers in Ukraine and some European countries

M. B. Demchuk — 2025-09-04

Calcium channel blockers have long remained an important class of antihypertensive agents due to their clinical benefits in the treatment of patients at high risk of cardiovascular, cerebrovascular, and renal complications.

Aim. To analyze the dynamics of drug consumption in the group of calcium channel blockers in Ukraine (for 2021-2023) and compare the consumption indicators with data from some European countries, in particular Estonia, Croatia, and Norway.

Materials and methods. The study was conducted using data from the State Register of Medicines of Ukraine and the analytical system for pharmaceutical market research “Proxima Research” of the company “Morion”. The consumption analysis of the drugs studied was performed using the ATC/DDD methodology recommended by the WHO. The indicator of DDDs per 1,000 inhabitants per day (DID) was used as the unit of measurement. Data on the calcium antagonist consumption in other European countries were obtained from the relevant national registries.

Results and discussion. It was found that the consumption of calcium antagonists in the domestic pharmaceutical market during 2021-2023 fluctuated slightly from 23,624 DID to 21,437 DID, i.e. it decreased by 9.26 %. The highest consumption volumes were for amlodipine (from 17,845 DID in 2021 to 15,245 DID in 2023), lercanidipine (from 2.43 DID in 2021 to 3.21 DID in 2023) and nifedipine (from 1,464 DID in 2021 to 1,196 DID in 2023). The highest consumption among combined drugs based on calcium channel blockers was observed for drugs combining amlodipine with indapamide. During the period analyzed, their consumption increased by 15 %. A comparison of the consumption of medicines from the group of calcium channel blockers in Ukraine, Croatia, Estonia, and Norway shows both numerous similarities and individual national differences. In all the countries considered, the leading positions in terms of consumption are occupied by amlodipine and lercanidipine. In Norway and Ukraine, the consumption of nifedipine remains stable, ranking third in the structure of the group analyzed. Estonia is characterized by a significant intake of nitrendipine, the share of which was 8.64 % in 2022 and 8.15 % in 2023. At the same time, a feature of the pharmaceutical markets of Croatia and Estonia is the relatively high level of lacidipine consumption.

Conclusions. The analysis of the consumption of calcium channel blockers in 2022–2023 revealed both pan-European trends and country-specific features of pharmacotherapeutic practice. In all the countries studied, the highest consumption volumes are for amlodipine drugs. Lercanidipine consistently occupies the second position, demonstrating a gradual increase in consumption. At the same time, individual approaches to the prescription of calcium channel blockers are observed in each country; they are formed under the influence of national experience, pricing policy and the level of availability of individual drugs in the domestic market.

Comparative characteristics of hypolipidemic drugs for the rational management of the pharmacy range

O. V. Tkachova — 2025-09-04

The high prevalence of cardiovascular diseases in Ukraine and the world ensures a consistently high demand for hypolipidemic drugs. The rational formation of the pharmacy range of these drugs is a key task for the pharmaceutical industry and affects the effectiveness of therapy, patient adherence and economic availability of treatment.

Aim. To analyze the most in-demand and physically available hypolipidemic drugs in the pharmaceutical market of Ukraine, taking into account their economic and physical accessibility for the rational formation of used pharmacy range.

Materials and methods. The study used the content analysis methods to systematically collect and process data on lipid-lowering drugs. The drugs were grouped according to active ingredients, manufacturers, and average retail prices to identify key trends in the range formation. Economic accessibility was assessed based on the cost of the defined daily dose (DDD) for the main indication in adults, which allowed to compare treatment costs between drugs from different manufacturers. Data were collected in June 2025 and from scientific publications covering the period of 2018–2025.

Results and discussion. A total of 319 lipid-lowering drugs registered in Ukraine as of June 1, 2025, were analyzed. Statins accounted for the largest share (84 %), confirming their dominance in the treatment of dyslipidemia. Foreign-manufactured drugs comprised 83 % of the range, while domestic medicines accounted for only 17 %. Monotherapy drugs predominated in the market (86 %), whereas combined drugs made up only 14 %. The example of the drug “Tricor^®” demonstrated significant differences in the physical availability of hypolipidemic drugs in different cities of Ukraine. The analysis of economic accessibility using the DDD cost method revealed variability in the cost – from 1.15 UAH to 7.85 UAH per DDD – and the monthly cost of lipid-lowering therapy ranged from 34.50 UAH to 235.50 UAH.

Conclusions. The analysis conducted will allow pharmacy managers and pharmacists to make informed decisions regarding the management of the hypolipidemic drug range, taking into account both physical availability and economic accessibility.

The introduction of electronic prescriptions in Ukraine as an important component of the electronic healthcare system: the experience of pharmacists

U. V. Khomut — 2025-09-04

The electronic prescription plays an important role in the digitalization of the healthcare system in Ukraine and is an important tool for managing the supply of medicines. The introduction of e-prescriptions brings the national healthcare system of Ukraine in line with international standards, in particular in the context of European integration obligations. The e-prescription provides transparency, accounting and control of the turnover of prescription drugs, contributes to the rationalization of pharmacotherapy and increases the responsibility of all participants in this process.

Aim. To analyze the impact of e-prescriptions on the work of pharmacists, assess the advantages and problems they face during their introduction, as well as determine future development directions for the e-prescription system to improve the efficiency of pharmaceutical services.

Materials and methods. The methods used included questionnaire surveys, analysis and synthesis, formal-logical, semantic, comparative, and systemic methods. The data analysis was performed using Microsoft Office Excel and STATISTICA 12.

Results and discussion. Our study found that the level of satisfaction among pharmacists with the e-prescription system implemented in Ukraine was quite high, with an average score of 7.79±2.02. According to the survey results, the average value of the number of e-prescriptions dispensed by one pharmacist during the working day was 6.95±0.41 prescriptions. At the same time, the average number of e-prescriptions for antibiotics was significantly lower – 1.60±0.19 prescriptions per day. Additionally, the average time to dispense one e-prescription, as reported by the respondents, was 2.63 minutes. The positive aspects of electronic prescribing that were most frequently mentioned in the free-text responses were safety of avoiding defects inherent in paper prescriptions (262) and the reduction in the likelihood of uncontrolled antibiotic consumption (295). However, respondents also described several disadvantages of electronic prescribing of medicines.

Conclusions. The results of the study have shown that the introduction of the electronic prescription in the pharmacy practice of Ukraine is an important step towards the digitalization of pharmacy and strengthening control over the turnover of prescription drugs, particularly antibiotics. Most pharmacists support the idea of the e-prescription as a tool for rationalizing the drug dispensing process, reducing abuse, and increasing the transparency of pharmaceutical care.

The study of praxeological aspects of pharmaceutical ethics in the performance of professional duties

I. P. Stechyshyn — 2025-09-04

The modern healthcare system sets pharmacists not only the task of providing consumers with high-quality medicines, but also high ethical requirements in interactions with visitors, physicians, and other participants in the medical process. Proper performance of professional duties is essential for building trust in the pharmacist. A significant role is played by the praxeological approach, which allows us to systematize the aspects of pharmaceutical ethics.

Aim. To study the praxeological aspects of pharmaceutical ethics manifested during the professional activities of pharmacy specialists; to substantiate their importance for providing high-quality, ethically grounded pharmaceutical care, for the formation of a patient-centered service model, and the prevention of professional and ethical violations.

Materials and methods. The study was conducted via an online survey of pharmacy employees (March–May 2025). The questionnaire included demographic and specialized sections with open- and closed-ended questions. The number of respondents (304) was determined using the sample observation method (A. N. Kolmogorov’s method). Responses of pharmacy workers from different regions of Ukraine were analyzed. Methods of statistical analysis, comparison, graphical data interpretation, as well as logical and ethical interpretation of results in accordance with the provisions of the Code of Ethics of the Pharmaceutical Worker of Ukraine were applied.

Results and discussion. The overwhelming majority of respondents (97.3 %) are guided by consumer interests, demonstrating patient-centricity. At the same time, 93.4 % recognize the impact of commercial incentives. Only 23.7 % always offer a cheaper analog, while 75.0 % do so only upon request, thereby limiting the consumer’s right to choose. Regarding communication with pharmacy visitors: 44.7 % always explain the way of drug administration, 43.4 % – only upon request, and 11.8 % – when possible; 69.7 % regularly ask clarifying questions; 78.9 % provide information on adverse drug reactions. No cases of systematic dispensing of prescription medicines without a prescription were reported, although 28.9 % avoided a direct answer. The necessity of a prescription is explained by 53.9 % of pharmacists, while 17.1 % refuse dispensing. In general, there is a significant difference between the declared ethical norms and the actual practices of respondents, indicating the need for systematic ethical support and continuous training.

Conclusions. Most respondents adhere to basic ethical principles – patient-centricity, responsible information provision, and harm prevention. At the same time, the impact of financial incentives and selectivity in communication remain challenges requiring correction through professional training, ethics workshops, and increased self-control.