Social Pharmacy in Health Care

Assessment of the efficiency of implementation of medical information systems: results of a survey of pharmaceutical workers

Iu. V. Korzh — 2025-07-01

In the context of active digital transformation of domestic healthcare, special attention is paid to the implementation of medical information systems, in particular in pharmacies. The effective functioning of medical information systems contributes to improving the quality of pharmaceutical services to the population and ensures the performance of state programs, in particular "Affordable Medicines".

Purpose. To assess the effectiveness of the level of implementation of medical information systems in the practical activities of pharmacy establishments and identify the main problems that arise among pharmaceutical workers during the practical application of systems, based on the analysis of survey results.

Materials and methods. The study used the results of a sociological survey of 833 pharmaceutical workers, conducted in September 2024 in electronic format. The questionnaire contained 20 questions divided into three thematic modules: general information about the respondents, assessment of the effectiveness of the implementation of medical information systems, as well as identification of technical and organizational problems of their implementation. In the process of conducting the study, a set of methods was used: general scientific (analysis, synthesis, generalization), theoretical (structural and system analysis), as well as practical, in particular, a sociological survey.

Results and discussion. The survey results showed that the vast majority of pharmaceutical workers positively assess the implementation of medical information systems, in particular regarding the convenience of electronic prescription redemption, automation of drug accounting and interaction with the National Health Insurance Fund. The most common systems were “Pharmacy 911”, “SKARB” and “Helsi”. At the same time, problematic issues of using these systems were identified, especially, uneven implementation, complexity of authorization, restrictions on the availability of medicines, as well as instability of technical support. Analysis of respondents' responses showed different levels of experience in using medical information systems, as well as a significant impact of external factors (lack of electricity, Internet, etc.) on the quality of the systems' operation. Pharmaceutical workers indicated the need to improve the functionality of medical information systems, simplify the authorization process, increase the level of digital literacy of personnel and develop software quality standards. Based on the generalization of the research results, the main areas that require systemic improvement were identified in order to increase the efficiency of the functioning of medical information systems as a modern effective tool for integrating pharmacy institutions into the national electronic healthcare system.

Conclusions. The results of the study revealed a number of technical, organizational, and informational problems that require systemic improvement. It has been determined that the effective functioning of medical information systems in pharmacies requires a comprehensive approach, including: stable technical support, simplification of authorization, increasing the digital literacy of pharmacists, integration with other electronic health systems, development of communication between medical and pharmaceutical workers, implementation of quality standards and systematic monitoring.

Analysis of the state of medical and pharmaceutical care provided to cancer patients under the conditions of the healthcare system reform and martial law in the country

M. R. Matushchak — 2025-07-01

Organizing the provision of effective and affordable medical and pharmaceutical care to cancer patients is an important task in the development of national healthcare systems in any country.

Aim: to analyze the state of medical and pharmaceutical care provided to cancer patients under the conditions of reforming the healthcare system and martial law in the country.

Materials and methods. Historical, analytical-comparative, graphic, logical, organizational-economic, mathematical-statistical methods of analysis were used. Data from special literature, analytical materials presented on the website of the Ministry of Health and the National Health Service of Ukraine were studied.

Results and discussion. It was found that in 2025, compared to 2024, the amounts of contracts concluded in Ukraine increased (by 5.5 % in chemotherapy and 7.27 % in radiology). It was proven that in the structure of contracts for servicing cancer patients in 2025, the dominant positions were occupied by healthcare institutions of municipal ownership (90.8 % – chemotherapy and 84.47 % – radiology). There was an uneven distribution of the number and amounts of contracts by regions of the country according to data of 2025. The highest values of these indicators were in the city of Kyiv, and the lowest in the Luhansk and Cherkasy regions; 17 regions of the country signed only one contract for radiological treatment and support of cancer patients. On average, one contract for the provision of chemotherapy services accounted for 24.39 million UAH, and for radiological treatment – 72.07 million UAH. In the case of chemotherapy, the conditional cost of one contract ranged from 7.17 million (Donetsk region) to 88.44 million UAH (Vinnytsia region), and for radiological treatment – from 21.27 million UAH (Kherson region) to 142.87 million UAH (Vinnytsia region). Under contracts for chemotherapy in 2024, compared to 2022, the amounts of contracts concluded increased by 18.78 % and the actual payment for services by 19.17 %, while for radiological treatment by 15.36 % and 18.99 %, respectively. It was determined that in 2023 the state purchased medicines for cancer patients in the amount of 2,136,971.5 thousand UAH, and in 2024 there was a significant decrease in this indicator (-9.36 %) to 1936975.2 thousand UAH. In the future, the state plans to increase spending on meeting the needs of cancer patients in these drugs.

Conclusions. The resource support of the process of providing medical and pharmaceutical care to cancer patients in Ukraine has been studied. The presence of regional features of the development of this process, as well as positive trends in the increase of the amounts of contracts concluded and payment for the cost of providing care to cancer patients in Ukraine during 2022-2024, has been proven.

Organization of the health system in Bulgaria - focus on payment and affordability of medicines

Z. Mitkova — 2025-07-01

Aim. The aim of the study is retrospective review and analysis of implemented measures for improving access to patients' therapy in Bulgaria.

Materials and methods. The study is based on data from officially published regulations and laws, as well as publications on cost control measures in healthcare and their impact on patients and government spending. Mechanisms of regulatory institutions introduced through laws and regulations are also mentioned in the analysis.

Results and discussion. The actions adopted are divided into several groups in order to examine all aspects of medicines affordability - mechanisms for cost control affecting access to medicines, patients' co-payment, and physical availability of medicines. The external reference pricing, Health technology assessment (HTA), discounts and negotiations, regressive scale for price calculation, generics price cap, budget cap and payback mechanism, therapeutic effect monitoring are used for medicines price setting and control. It was found that despite the decrease in drug prices, there is a noticeable increase in government spending, as well as an increase in household spending. The retail pharmacies established in the country are mainly in the large cities. About 32 municipalities could not provide patients' access to medicines. The financial cost implications are substantial and the burden for patients is increasing.

Conclusion. Efforts in recent years have focused on reducing costs for both patients and the population as a whole. The study found that the introduction of reference pricing (internal and external), health technology assessment, budget constraints, negotiations, and generic drug policies do not contribute to patient access to therapy. Cost control measures implemented at this stage are not as effective as expected. In addition, it was found that household spending on medicines has been increasing in recent years, and all policy measures taken do not contribute to supporting patients financially.

The role of pharmacies in implementing modern protocols for the pharmacotherapy of type 2 diabetes mellitus

N.V. Zhabotynska — 2025-07-01

The incidence of diabetes in different countries ranges from 1.5 to 10% and only about 50% of patients with type 2 diabetes achieve glycemic control. Therefore, studying factors that contribute to improving disease control and preventing complications is relevant.

The aim is to study the capabilities of a pharmacy in implementing modern guidelines for pharmacotherapy of type 2 diabetes based on an analysis of the assortment and sales of the hypoglycemic drugs over a 3-month period.

Materials and methods: assortment of hypoglycemic drugs in a pharmacy, sales report of various pharmacological groups of hypoglycemic drugs and fixed-dose combination drug. Analytical and statistical methods were used in the research.

Results. Analysis of the assortment of hypoglycemic drugs in the pharmacy showed the presence of five out of six pharmacological classes recommended by modern guidelines: Biguanides, Inhibitors of sodium-dependent glucose cotransporter type 2, Antagonists of glucagon-like peptide type 1 receptors, Dipeptidyl peptidase 4 inhibitors and Sulfonylureas. Thiazolidinediones are absent in the pharmacy. This range of hypohlygemic drugs corresponds the international guidelines and the Unified Ukrainian Clinical Protocol for Medical Care for Type 2 Diabetes. Analysis of sales of hypoglycemic drugs in the pharmacy showed that the leading positions in sales are occupied by Biguanides and Sulfonylureas. Combined hypoglycemic drugs in the pharmacy are represented by combinations of Biguanides with Sulfonylureas, with Dipeptidyl peptidase 4 inhibitors and Inhibitors of sodium-dependent glucose cotransporter type 2. But sales of combined diabetes-lowering drugs in pharmacies account for only 28.34%, with 40.3% of them being sales of the combination of Metformin and Glibenclamide.

Conclusions. The results of the research showed that modern guidelines for pharmacotherapy of type 2 diabetes are partially implemented in pharmacies, but at the same time, patients' access to drugs that allow for effective control of glycemia is ensured. The key negative trends are the low percentage of sales of drugs for the prevention of complications of diabetes and fixed-dose combination drug. To improve the practical implementation of guidelines, it is necessary to pay more attention to the study of dynamic changes in international guidelines and the Ukrainian Clinical Protocol For Medical Care For Type 2 Diabetes during the continuous professional development of pharmacy specialists.

Trends in the nootropic drugs market in the republic of Uzbekistan

D.U. Saydalieva — 2025-07-01

The increasing incidence of cerebrovascular and cognitive disorders in Uzbekistan, driven by a growing information load and an aging population, has led to a heightened demand for effective nootropic medications. The pharmaceutical market is adapting to this demand through a diversified range of drugs, including both imported and domestically produced products.

Aim. This study aims to evaluate the dynamics of the nootropic drug market in the Republic of Uzbekistan from 2015 to 2024 in both physical and monetary terms, including the analysis of import volumes, domestic production, key market players, dosage forms, and trends in international nonproprietary names.

Materials and methods. The study utilized aggregated data on the registration, import, and production of nootropic drugs classified under ATC group N06BX. Marketing analysis methods and qualimetric tools were applied to identify quantitative trends, structural shifts over the study period.

Results and discussion. The article presents an analysis of the dynamics of the nootropic drug market in the Republic of Uzbekistan over the period 2015–2024. It examines quantitative changes in both physical and monetary terms, as well as the structure of imports and domestic production. Key trends are identified, including an increase in nootropic consumption up to 2022 followed by a subsequent decline, the strengthening of domestic manufacturers' positions, and changes in the assortment and consumption structure by international nonproprietary names. A comparative analysis of supplies from CIS and non-CIS countries is provided, along with an evaluation of the activity of leading domestic companies. Particular attention is given to dosage forms. The findings of the study may be used to assess the current state of the pharmaceutical market and to inform strategic planning for the development of the nootropic drug sector in Uzbekistan.

Conclusions The nootropic drug market in Uzbekistan shows cyclical dynamics with strong domestic development potential. Market fluctuations reflect clinical guideline revisions and increased emphasis on evidence-based prescribing. The study highlights the growing role of local manufacturers and the shift toward more complex and effective nootropic formulations.

Assessment of cost aspects of prevention of excessive thromboformation in patients with COVID-19 in Ukraine

O.M. Semenov — 2025-07-01

COVID-19 is a multisymptomatic infectious viral disease, one of the main complications of which is excessive blood clot formation, which can lead to myocardial infarction and stroke.

The aim of the study was to assess the cost aspects of market offers of medicines recommended for the prevention of excessive thrombosis in patients who have had COVID-19 and are prone to thrombosis.

Materials and methods. To conduct the study, data from the State Register of Medicines of Ukraine, Compendium, and the Register of Wholesale Prices for Medicines.

The data of the Protocol "Provision of medical care for the treatment of coronavirus disease (COVID-19)" has been systematized and summarized.

Additionally, international recommendations for providing care to patients with COVID-19 were studied through Embase Global Health, Medline, PubMed.

The following methods were used: systematic review, documentary, bibliographic, statistical, analytical, comparative, generalizing, informational.

Results. In Ukraine, the protocol "Providing medical care for the treatment of coronavirus disease (COVID-19)" is in effect, which recommends that after COVID-19, patients with a risk of excessive thromboembolism continue anticoagulant therapy with oral anticoagulants, which include direct thrombin inhibitors (Dabigatran) and direct factor Xa inhibitors (Rivaroxaban, Apixaban). As a result of the conducted studies, it was found that the cost of a 30-day course of preventive treatment for a patient is: apixaban 2.5 mg - 1398.00 UAH; pradakasa 300 mg - 1523.40 UAH; xarelto 15 mg/20 mg - 1871.94 UAH. The cost of pharmacotherapy with apixaban 2.5 mg is the lowest compared to xarelto by 1.3 times.

Conclusions. Prophylactic pharmacotherapy with oral anticoagulants for patients at risk of excessive thromboembolism after COVID-19 should lead to normalization of blood coagulation status and prevent thromboembolism

Analysis of trends in the generation and disposal of pharmaceutical waste in domestic healthcare institutions

V. V. Vinohradskyi — 2025-07-01

For many countries of the world, the problem of waste disposal is acute. This applies to both economically developed countries and developing countries. Hazardous substances contained in pharmaceutical and medical waste negatively affect the environment and human health.

Аim of the work was to investigate the existing problems in Ukraine regarding the management and disposal of pharmaceutical waste (PW) and to propose effective directions for overcoming these problems.

Materials and methods of the study: The study was conducted using databases on the Internet: data from the websites of research companies European Commission, Statista; data from the website of the Verkhovna Rada of Ukraine; scientific and metric databases - Scopus, Web of Science, etc. The methods used in the research were analytical, statistical, systemic, structural-logical and computational, as well as the materials provided by the internal reporting documentation of the departments of some domestic healthcare institutions (PHIs).

Results of the study. The dynamics of the formation of medical waste, pharmaceutical waste, the main indicators of the formation and management of pharmaceutical waste of hazard classes I-IV, the accumulation of PW during operation at waste disposal sites by hazard classes, the formation of pharmaceutical waste by hazard classes in Ukraine for 2019-2023 were studied. A general trend towards an increase in accumulated pharmaceutical waste at landfills is noted, which indicates the need to improve the processing infrastructure and more actively implement environmentally safe pharmaceutical waste management technologies. Optimization of these processes will minimize the negative impact on the environment and ensure sustainable use of natural resources. It is proven that to overcome the problem of pharmaceutical waste management and utilization in Ukraine, it is necessary to implement comprehensive and effective measures. The main directions for solving this problem are considered. A process model of the pharmaceutical waste management strategy in health care facilities is proposed, where each new stage of implementing the pharmaceutical waste management strategy begins only after the successful completion of the previous stage. The effectiveness of the pharmaceutical waste management system is determined by the level of achievement of the set goals of the pharmaceutical waste management process.

Conclusions. It is proven that the growth in pharmaceutical waste volumes in the period from 2019 to 2023 requires an improvement in the management system for such waste to minimize their negative impact on the environment. The growth of the accumulation of pharmaceutical waste in landfills is also a significant problem, requiring the development of new methods of disposal in order to avoid long-term environmental consequences. It is noted that updating and improving disposal technologies, in particular the introduction of environmentally friendly methods, will help reduce the number of pharmaceutical waste in landfills. It is proposed that in order to improve the management of pharmaceutical waste, it is important to improve the regulatory framework, strengthen control over the activities of health care institutions and FOs, and introduce strict sanctions for violations of disposal standards. In addition, the adaptation of international experience, in particular European disposal standards, will allow the implementation of more effective practices and reduce environmental and social risks for Ukraine.

Assessment of the availability of medicines under the reimbursement program for patients with type 2 diabetes in Vinnytsya region

O.P. Balicka — 2025-07-01

Aim: assessment of drug availability under the reimbursement program for patients with type 2 diabetes in Vinnytsya region.

Materials and methods of research. A set of regulatory legal acts on the organization of pharmaceutical support for patients with diabetes in Ukraine; data from scientific literature on the problems of organizing effective pharmaceutical care for patients with diabetes in Ukraine and in the world; patients with type 2 diabetes, doctors who provide primary medical care (family doctors), the State Register of Drugs (2024), the official Internet resource of the National Health Insurance Fund. Methods: historical; logical; comparative, semantic, bibliographical; graphical; mathematical and statistical.

Results. As a result of the study, a comprehensive assessment of the availability of drugs under the reimbursement program for patients with type 2 diabetes was carried out, which included an analysis of the current state of provision for patients with type 2 diabetes and an analysis of e-prescriptions created under the reimbursement program for 2019-2024. It was found that 45 names were registered by trade name (TN) - 80.0 % based on metformin (A10BA02), 7 names by TN (13.0 %) based on gliclazide (A10BB09), and 3 names by TN (7.0 %) based on glibenclamide (A10BB01). According to the results of the analysis of e-prescriptions created under the reimbursement program over the past 6 years, the leader among diseases in terms of the number of prescriptions were cardiovascular diseases – 2 481 626 e-prescriptions. The total number of prescriptions over the six years was 744 952. Metformin became the leading drug in terms of prescription frequency – 540 384 e-prescriptions were written for it. The largest number of prescriptions was written in cities – 431 821, which is more than 50 % of the total. In rural areas, this figure is significantly lower – 199 180, and in urban settlements – 113 951, which indicates an uneven distribution of access to treatment and, probably, a higher prevalence of applications in cities. There is a trend towards an increase in the number of prescriptions issued (from 103 711 e-prescriptions in 2019 to 140 412 e-prescriptions in 2024), which may indicate improved accessibility of medical services and medicines for patients.

Conclusions. As a result of the study, a positive trend was established in the number of e-prescriptions issued for oral hypoglycemic drugs in the Vinnytsya region, which indicates an increase in the availability of pharmaceutical care for chronic patients with type 2 diabetes and an improvement in the healthcare system as a whole.