From April 2023, according to the decision of the Ministry of Health of Ukraine, prescription drugs can be obtained in the pharmacy not only by paper but also by electronic prescription. The innovation has raised questions online: in comments users worry that the illegal drug trade will now increase, hospital queues will be longer, and people with chronic diseases and pensioners will find it harder to get the medicine they need. The news was picked up by Russian propagandists to show how the Ukrainian authorities “make life difficult for patients.” We explain whether the decision is really so inconvenient.
With the support of the USAID Health Reform Support project, VoxCheck analyzes and refutes public health narratives spread in the information space of Ukraine, Belarus, and russia on a weekly basis.
What will change?
The decision is not new: Ukrainians have been using electronic prescriptions to obtain drugs under the “Affordable Medicines” program since 2019. In August 2022, an electronic prescription was introduced for obtaining antibiotics. And from November 2022, e-prescriptions began to be used for dispensing narcotic and psychotropic drugs, which are used, in particular, to relieve symptoms in patients with complex diseases (oncology, complex injuries, heart attacks), treatment of deep mental and neurotic diseases, etc.
How to get a prescription for medicine during a blackout?
Currently, the introduction of an electronic prescription will take place gradually: during the transition period, the patient will be able to choose the type of prescription — electronic or paper. Currently, it is not known how long such a transition period will last — it will depend on the security situation in the country, as well as on the situation with electricity supply, in particular in health care facilities. So if there is no electricity or communication in the medical facility, the doctor will be able to write the patient a paper prescription on the appropriate prescription form.
In addition, discounted drugs and drugs produced directly in the pharmacy will continue to be sold with paper prescriptions. If the patient does not have a mobile phone, the doctor will print out a prescription with a code to redeem the prescription at the pharmacy.
Does this mean that all medicines require a prescription?
No, the Ministry of Health of Ukraine does not expand the list of prescription drugs and does not make all drugs prescription. That is, all those medicines that were previously subject to a doctor’s prescription will be available from April using an electronic prescription. This list may include, in particular:
- hormonal drugs (including contraceptives);
- drugs for the treatment of blood pressure and heart diseases;
- some anthelmintic drugs;
- some antihistamines;
- blood thinners;
- antidepressants, neuroleptics, and relaxants;
- steroid medicines;
- some medicines against pain, cough, and sedatives.
No matter how familiar and safe these drugs seem, their use carries increased risk. That is why their appointment should be done exclusively by a doctor. After all, only a medical professional can choose the correct active ingredient, dosage, and duration of medication that are safe and effective.
To find out whether you need a prescription for a specific drug, you should look at the instructions. You can find the instructions for the desired drug by using the services of online pharmacies or the website of the State Register of Medicinal Products of Ukraine. In the “dispensing conditions” column, “by prescription” will be indicated. In the electronic prescription, only the active substance will be indicated, without indicating the brand name of the drug, so the patient will be able to choose the medicine independently according to his budget.
In December 2022, experts of the Reform Index (a project of the “Vox Ukraine” analytical center) estimated the positive impact of the adoption of the law on strengthening control over the dispensing of medicinal products at +1.5 points. The law prohibits pharmacies from selling drugs without a prescription and medical professionals from prescribing them without giving patient a prescription. It also serves as a basis for the full implementation of an electronic prescription. Read more about the project and evaluation methodology here.
Do I need to sign a declaration to get a prescription?
According to the innovations, patients will be able to receive an e-prescription regardless of whether they have made a declaration with a family doctor. Doctors of medical institutions of all forms of ownership will be able to write out an e-prescription: state, communal, and private clinics, as well as doctors who are private entrepreneurs.
Instead, to receive an e-prescription, the patient must be registered in the electronic health care system (EHS). If the patient is not in the electronic system, any doctor can register him already during the visit. In particular, thanks to access to the patient’s medical record in the EHS, the doctor will be able to view the data history or see what medications the patient took before that.
In addition, any doctor who examines a patient can issue an e-prescription. For example, a therapist, surgeon or cardiologist. If the patient has changed his place of residence, he can get an e-prescription from any doctor in the nearest healthcare facility.
How to buy medicine by e-prescription?
During a visit to a medical institution, the doctor will write an e-prescription in the system, and the patient will receive an SMS message to the phone with the number of the prescription and a unique confirmation code. The patient must tell the pharmacist the SMS code directly at the pharmacy. To get a code for an e-prescription, it is not necessary to have a smartphone — any mobile phone will do.
If the patient has deleted the text message with the prescription number, he needs to contact the doctor through any messenger to form a new request.
In the end, patients will not have to stand in queues, because the doctor will be able to issue a repeat e-prescription remotely. To receive an e-prescription remotely, the diagnosis and the first appointment from the attending physician must be recorded in the system. Those who have chronic diseases and are being treated for a long period of time will also be able to receive an e-prescription remotely.
In rural areas, where access to medical facilities is limited, paramedics can write paper prescriptions. However, only doctors can prescribe prescriptions for narcotic (psychotropic) drugs, poisonous and potent drugs, as well as drugs included in the “Affordable Medicines” reimbursement program.
The patient will be able to buy medicine with an e-prescription at a pharmacy that is registered and operates in the EHS. If the management of the pharmacy does not do this within the prescribed period, the institution’s administration will bear the responsibility provided for by law. You can find a pharmacy that dispenses medication by electronic prescription by using a special dashboard that will tell you the address of the nearest pharmacy to you. To do this, it is enough to enter or select from the list in the search bar the name of your locality.
Like a paper electronic prescription, it will be valid for 30 days, or 10 days if it is a psychotropic drug.
An exception will be occupied territories and zones of active hostilities. Pharmacies in these settlements will continue to be able to dispense prescription drugs (except narcotic or psychotropic drugs) to patients without a doctor’s prescription.
In addition, military administrations, units of the Armed Forces of Ukraine, as well as involved volunteer and charitable organizations can purchase prescription drugs for wartime needs in bulk directly from distributors and for this, a prescription is not required.
No additional changes or restrictions on the release of medicinal products for animals are foreseen. As before, Ukrainians will be able to purchase medicinal products for animals at a pharmacy with a veterinary (paper) prescription.
Will drugs start to be traded illegally?
It is impossible to completely exclude corruption risks. Some “pharmacies” work without a license to carry out wholesale and retail trade, or even those that have a license, sin by selling “from under the shelf”.
But if earlier it was possible to buy medicine without a prescription or to fake it, the introduction of e-prescription will strengthen the control and transparency of the dispensing of prescription drugs in pharmacies.
Violators who sell drugs without a prescription will be punished in the form of a fine in the amount of 65-129 thousand UAH (50-100 tax-free minimums). If a repeated violation is detected, the fine can reach UAH 259,000 (200 tax-free minimums).
In order to avoid buying falsified medicines, the State Service of Medicines and Narcotics Control of Ukraine advises not to buy medicines from private individuals, from the announcements, on sites where the contact and address of the pharmacy are not indicated, there is no logo with a hyperlink to the valid license. In the premises of the pharmacy, information about the availability of a current license can be found in the consumer’s corner or asked from the pharmacist.
Also, the Ministry of Health does not recommend using dubious services that offer online sales of prescriptions. Do not waste your time, money and most importantly do not risk your health, consult a doctor! Take care of yourself and your health!
This information piece was produced with the assistance of the United States Agency for International Development (USAID), provided on behalf of the people of the United States of America. This article’s content, which does not necessarily reflect the views of USAID, the United States Government, is the sole responsibility of Deloitte Consulting under contract #72012118C00001.
The authors do not work for, consult to, own shares in or receive funding from any company or organization that would benefit from this article, and have no relevant affiliations