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Medicines have not become cheaper: why pharmaceutical reform only confused the marketThe reform of state regulation of drug prices in Ukraine, which started at the beginning of 2025, did not achieve its goal of
making medicines cheaper. The ban on marketing agreements led to an increase in prices and super-profits for pharmaceutical
manufacturers, and the National Catalog did not reduce the cost of medicines.
”, — write: unn.ua
The large-scale reform of the pharmaceutical market, which started at the beginning of 2025 and aims to make drug prices more transparent, predictable, and accessible for patients, has not yet brought the desired results. Moreover, the reform is criticized and causes controversy among both specialists and patients.
One of the primary stages of the reform was the ban on marketing agreements between pharmacies and manufacturers. According to the reformers’ plan, this step was supposed to reduce drug prices. However, in practice, it had the opposite effect. As a result of the ban, pharmacies lost a source of compensation that allowed them to reduce the retail price for the end consumer. As a result, according to Minister of Health Viktor Liashko, in April 2025, inflation in the pharmaceutical market reached 13.9%.
The increase in drug prices is confirmed by UNN monitoring data: imported drugs, such as “Betaloc”, “Glucophage XR”, “Synjardy”, have become more expensive.
Meanwhile, pharmaceutical manufacturers, who form more than 70% of the drug’s cost, save approximately UAH 500 million per month on the marketing ban, economist Oleksiy Kushch said. Thus, if the economist’s calculations are correct, in four months without marketing agreements, the pharmaceutical manufacturer earned UAH 2 billion more. That is, the reform played “into the hands” of pharmaceutical manufacturers, leading them to super-profits. Meanwhile, Ukrainian patients were left without social programs and discounts on medicines, which pharmacies provided to their customers thanks to marketing agreements.
Another key element of the reform was the creation of the National Catalog, which as of June 2025 includes over 3,500 items for which wholesale-release prices have been set. However, as evidenced by the results of a study by Proxima Research, the main goal of introducing this tool, reducing the cost of medicines for consumers, has also not been achieved.
After all, the declared prices on average exceed market prices by 20%. This does not mean an immediate price increase, but it shows that manufacturers are factoring in risks in advance.
Let’s addAt the first stage, 2523 items from the National List were included in the National Catalog, of which 406 were innovative drugs, and the rest were generics. During the first five months of 2025, about 2000 product items with declared wholesale prices were sold on the market. This accounts for 25% of the total sales volume in natural terms and 21% in monetary terms.
At the same time, within the framework of the reference pricing mechanism, 4171 positions of medicinal products from the National List were initially considered. However, for only 199 of them, it was possible to determine the maximum wholesale price based on data from four reference countries. Of this number, only 66 drugs were sold in pharmacies. All other referenced drugs did not get into the catalog at all, as their reference price is on average 36% lower than the market price, which makes their sale unprofitable.
This creates a risk of a shortage of important medicines as early as November 1, 2025, when the transition period ends. Thus, the reform, which was supposed to reduce prices, actually creates conditions for their increase or the disappearance of drugs from the market.
The problem is also confirmed by doctor Ivan Chernenko. In an exclusive comment to UNN, he said that in reality, Ukrainian doctors are forced to look for workarounds to provide patients with the necessary medicines. The reason is not a lack of funds, but the imperfection of state regulation.
According to the doctor, in order to circumvent the newly created state system, medical institutions are forced to resort to non-transparent solutions — overstating prices for cheaper drugs to compensate distributors for the cost of critically needed drugs. Thus, overstating the final purchase check. Such actions expose the hospital administration to danger and attention from law enforcement agencies, which may consider this a violation of tender procedures by the medical institution.
Hospitals face the problem of purchasing medicines because, due to price regulation, distributors simply do not participate in tenders. For example, the drug Phytomenadione, necessary for newborns – hospitals cannot officially purchase it. All because of the state-set price “ceiling”, which is actually lower than the market price. Then they have to negotiate with distributors and raise prices for other drugs to the “ceiling”. And all this is to compensate for the losses incurred by the distributor when selling the drug at the reference price. And all this is so that medicines can be bought officially, through Prozorro.
RecallIn April 2025, Cabinet of Ministers resolutions №795 came into force, which form reference prices for medicines. The idea of reference pricing is to establish a fair and controlled price for medicines, focusing on the average cost of the drug in Europe.
However, in reality, this led to the opposite effect. The BF “Patients of Ukraine” also talks about the increase in drug prices instead of their reduction. According to the head of the foundation, Inna Ivanenko, patients do not yet feel a significant improvement in the cost or availability of medicines. Over the past three months, there has been no noticeable decrease in drug prices.
Thus, innovations that were supposed to improve access to medicines and reduce their cost for Ukrainians have created conditions in which drugs disappear from the market. And hospitals are forced to resort to illegal schemes to provide patients with the necessary drugs.