APPROACHES FOR DEVELOPING MODELS OF FUNCTIONING AGENCIES OF HEALTH TECHNOLOGIES ASSESSMENT IN UKRAINE

Abstract

Introduction

The modern period of reforming thehealth care system (HCS) in Ukraine and approaches for providing medical and pharmaceutical care put the epicenter requirements for services, which are provided, the need of efficiency, safety, and economy at the level of individual customer service – citizen and on national level. Therefore, in recent years to the concept of “Health Technologies Assessment” (HTA) is paid as much attention as certain scientists, scientific schools as an institutions of the state power.

Objective: according to literature sources, justifythe topicality of creation the Agency of HTA inUkraine and developing models of their functioning.

Material and Methods

Bbibliographic, systematic and logical methods

Results and discussion

Due to the results of studying the available literature sources, it is indicated that there is no unified universally accepted interpretation of the term HTA. However, all determination are united that there is no need in medical technology (MT) at all – the need is in the final result of the health and quality of life. Taking into account the idea of man-progressive paradigm of building HCS, we have proposed the model of justification the necessity of introducing the methodology of HTA in national practice selection MT as the intersection of planes psychological, social, legal, organization and market aspects of protecting the interests of individual citizens, certain territorial community and the state in general.

Now inUkrainethere is no unified coordination center of HTA. However, there is laid some foundation of the process of introduction the methodology of HTA in HCS. In favor of this it is evidenced a considerable number of publications on HTA at the national professional periodicals, and the creation in 2012 of non-budget public-initiative Ukrainian agency on HTA of healthcare and conducting the thematic conferences, round table in Parliament, trainings with participation of international experts. Nevertheless, the greatest achievement on the way of HTA is the creation of the Expert Committee on the selection and using the essential medicinesas a prototype of a national agency on HTA. However, the Expert Committee is an advising institution of the Ministry of Public Health of Ukraine, which does not work on a regular basis due to financial restrictions, which significantly reduces its functional range.

By analogy to the foreign experience of the existence of HTA systems, we consider to recommend the implementation inUkrainethe three-level model of its agencies: national, regional, local. Since, in national HCS in general and pharmacy in particular there is positive practice of functioning the three-level system – formulary, pharmacovigilance, quality drugs assurance. The next step for the implementation of the national strategy should be the creation the Ukrainian agency of HTA. For its financing, we predicted a mixed model: the state budget costs and the future fund of obligatory medical insurance. However, the financing of regional or local agencies on HTA should avoid funds of companies that will submit an application for reimbursement of cost of their drugs.

Conclusions

The using of international experience in the system HTA help to implement this system in Ukraine to improve the quality of medical and pharmaceutical care at the national, regional and local levels. To do this, we need to start creating agencies of HTA, which will be a serious tool for the management of the ministry of Public Health, regional health care departments of the regional state administration, and health care institutions in making decisions on purchases MT. For funding agencies of HTA in Ukraine is the most appropriate mixed model. The justification of creation of state center of MT selection that will be reimbursement from the budgets of different levels, we propose to consider it in the plane crossing 5 major aspects: psychological, social, legal, organization, marketing.