
Ukrainian medical guidelines and protocols need to be updated when new international recommendations appear - MP
Kyiv • UNN
Medical protocols in Ukraine are not updated despite new international recommendations for the treatment of epidermolysis bullosa. The Swedish company Molnlycke maintains a monopoly on the medical dressing market due to outdated guidelines.
Medical guidelines and protocols should be updated promptly if new international recommendations appear. This was stated by Yana Zinkevych, a member of the Verkhovna Rada Committee on National Health, Medical Assistance and Medical Insurance, in an exclusive commentary to UNN.
Context
Earlier, in a commentary to UNN, Valeriy Zub, a member of the Rada's relevant committee, said that the Verkhovna Rada Committee on National Health, Medical Care and Medical Insurance is working to develop a mechanism for dynamically updating national protocols to adapt to new evidence-based treatments and changes in international medical practice
Details
"Generally speaking, it looks like a logical idea. Because the TCCC protocol (Tactical Combat Casualty Care - a protocol that describes the procedure, requirements and provisions governing the provision of medical care to wounded soldiers directly on the battlefield - ed. That is, it is quite appropriate to update our protocols when new international recommendations appear, and not once every 5 years, as it is now," said Yana Zinkevych.
She added that she would support the initiative to promptly update medical records if "everything is properly written there.
Add
Back in 2016, a special commission approved an adapted clinical guideline that recommends using only products from the Swedish company Molnlycke Health Care to treat butterfly wounds. This document was based on recommendations and findings collected in 2012. It was supposed to be revised in 2019, but this did not happen. The Commission has not updated its recommendations for more than five years, despite the latest experience of international colleagues, which suggests that there are corrupt motives for its inaction. In 2017, this guideline formed the basis of a medical protocol for the treatment of patients with epidermolysis bullosa. In this way, "butterfly people" in Ukraine were deprived of the right to choose medical products for wound treatment, as no analogues to Swedish dressings were specified in the documentation.
The 2021 European Consensus on Practice Guidelines for the Treatment of Epidermolysis Bullosa published by the European Academy of Dermatology and Venereology advises doctors to use an individualized approach in the treatment of "butterfly people." "The choice of wound treatment strategy should take into account efficacy, patient preference, and cost-effectiveness," the document says.
The economic feasibility is particularly related to the fact that patients with epidermolysis bullosa have to use many wound dressings throughout their lives, and some manufacturers, such as Molnlycke Health Care, are very expensive.
At the same time, European doctors in the guideline specified a number of manufacturers of dressings that can be used to treat the wounds of patients with epidermolysis bullosa. That is, they allow patients to choose the medication that suits them best. Moreover, the Europeans advise doctors to use gauze if it is not possible to use specialized dressings. The 2024 clinical practice guideline for the treatment of epidermolysis bullosa neonatorum, published in the British Journal of Dermatology, suggests a similar approach to preventing skin injury in diapered children.
However, in Ukraine, international recommendations are ignored and they stubbornly say that only Swedish dressings can be used for patients with bullous epidermolysis.
Recall
Earlier, UNN received information indicating that the Swedish company Molnlycke Health Care, which holds a monopoly position in the Ukrainian market of medical dressings for patients with epidermolysis bullosa, may be involved in financing the public union "Orphan Diseases of Ukraine", headed by Tetiana Kulesha. The union has actually become the mouthpiece of the company, helping to maintain Molnlycke's monopoly on the medical dressings market in Ukraine and lobbying for its interests.
In his public speeches, Kulesha constantly emphasizes that there is no alternative to Swedish bandages and defends Molnlycke products, despite the availability of high-quality and cheaper analogues that are successfully used in other countries.
Experts interviewed by UNN note that the situation around Molnlycke Health Care has clear signs of a conflict of interest and a corruption component. At the same time, attempts by other manufacturers to offer alternative dressings for public tenders are blocked due to the influence of Orphan Diseases of Ukraine and its leader.
Former Minister of Health Zoryana Skaletska emphasizedthat the Ministry of Health must look into the situation and do everything necessary to ensure the interests of patients. She emphasized that orphan diseases require special attention, because due to the rarity of these diseases, government agencies may not have enough information to respond quickly.