Ukrainian know-how from the Ministry of Health: how a new resolution destroys small pharmacies

Cabinet of Ministers of Ukraine Resolution No. 168 on drug prices will be appealed in court, because it was adopted with violations and will lead to the closure of small pharmacies in villages. Olena Prudnikova, head of one of the professional pharmacy associations, told UNN in an exclusive commentary, adding that the Ministry of Health does not listen to small businesses and protects only manufacturers.

Olena Prudnikova is the head of the NGO "All-Ukrainian Association "Mykolaiv Pharmaceutical Association "PharmRada" and takes an active part in the meetings of the working group headed by Deputy Head of the Office of the President Iryna Vereshchuk, which is working on changes to the government resolution on drug prices.

According to her, the Cabinet of Ministers' resolution was adopted with a gross violation of the law - it was not agreed with the State Regulatory Service, as required by current legislation. 

We will go to court, we have no other choice. It (the CMU resolution - ed.) was not agreed with the State Regulatory Service, this is a direct violation of the law, and we will go to court. The Ministry of Health gives us no other choice, because it does not listen to us and is not going to change it

Ukrainian know-how

The government resolution establishes a single model for regulating trade markups on all medicines sold in pharmacies. According to Prudnikova, this approach is unique even by world standards. 

The state (the Government of Ukraine - ed.) has taken the path that they abolished marketing until all 100% of medicines in Ukraine are referenced. This is Ukrainian know-how. Because nowhere in the countries of the European Union, the United States, or other countries is there such a thing that the state regulates prices for 100%. There, the state regulates prices only for medicines that it compensates, for which the state pays money

However, according to the proposals of the Ministry of Health, the Government decided to apply reference pricing to all drugs - by comparing the average cost in Eastern European countries (Poland, Romania, the Baltic States). At the same time, according to Prudnikova, Moldova was excluded from this list due to lobbying by pharmaceutical manufacturers.

I monitored the prices of medicines in Moldova and found out that some of our domestic manufacturers supply medicines to Moldova at half the price than they sell them inside our country. Plus, foreign-made medicines are also twice as cheap there. I believe that this is pure lobbying by manufacturers to throw out Moldova, because the price of medicines will be significantly reduced

Prudnikova, who owns two pharmacies in the Kyiv region, stressed that the Ministry of Health only listens to manufacturers.

Today, as always, we - small pharmacies, as never before, are not heard. They only hear those who make big money. Our manufacturers make the most money. The state does not regulate their profitability, but regulates the profitability of pharmacies. Although 85% of the price of medicines depends on manufacturers

In the last three years, 70% of pharmacies-sole proprietors have closed, the rest are under threat

Currently, the situation on the pharmaceutical market is turning into a critical one. During the years of the full-scale war in Ukraine, more than 70% of small pharmacies have ceased operations: out of 4,000, only about 1,200 remain. According to Prudnikova, after the new pharmaceutical market regulation comes into force, even these remnants are under threat.

It will end with the closure of pharmacies in small villages, because it is impossible to survive on that markup. The Ministry of Health ignores us. That is, the Ministry of Health has shown that it is not interested in providing medicines in the village, it only listens to the big ones

According to her, pharmacy associations appealed to the National Security and Defense Council with proposals to amend CMU Resolution No. 168, adopted in pursuance of the NSDC decision. 

In particular, pharmacy associations provided their proposals to change the markup formula to allow small pharmacies to survive. They propose to set a fixed markup of up to 35% - as provided for by the NSDC decision.

They (the Ministry of Health - ed.) rely on the NSDC decision, but we have proposed to make changes within the framework of this decision. The NSDC decision proposes to make differentiated markups, but not higher than 35%. We are asking for 35%, we are not asking for 20-25-15% as they (the Ministry of Health - ed.) did. Make it 35% for everything, and we will try to survive. We are not saying that we will survive, but we will try

 Let's add

The State Regulatory Service informed UNN that the draft resolution adopted by the Cabinet of Ministers of Ukraine on February 14 did not undergo approval with, as required by law.

At the same time, at the stage of development, the draft of the above-mentioned resolution No. 168 was not submitted for approval or consideration to the SRS. In this regard, the SRS did not make any decisions regarding the draft resolution

At the same time, the service stressed that the law on regulatory policy applies to all draft regulatory acts.

Recall

Resolution of the Cabinet of Ministers of Ukraine No. 168 of February 14, 2025 provides for new rules for regulating the pharmaceutical market. In particular, restrictions were introduced on markups on supply and marketing and retail allowances for all medicines, and not only for certain categories. In addition, the resolution prohibits retailers from entering into marketing agreements with pharmaceutical manufacturers, which allowed pharmacies to offer discounts to patients, implement social projects and train pharmacists.

The purpose of the resolution was to reduce drug prices and increase their availability to the population. At the same time, patient organizations warned that excessive regulation could lead to drug shortages, pharmacy closures in small towns and villages, and the cessation of social programs to support patients.