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Reimbursement Mechanism of the Costs of Insulin Products for Pharmacies

Cabinet of Ministers of Ukraine Resolution as of 23.03.2016, № 239 “Certain Issues of Insulin Products Costs Reimbursement” designates the reimbursement mechanisms for insulin products sold by the pharmacies to diabetic patients within the framework of pilot project. The reimbursement of insulin products costs shall be fulfilled at the rate of reference price for the medicinal product approved by the Ministry of Health of Ukraine.

These medicinal products shall be sold by prescription only. Diabetic patients were broken down into 11 categories. The patients shall receive their medication for a lowered price or for free in accordance with these categories.

The procedure for insulin products reimbursement foresees that the pharmacy warehouse should file monthly report on the medicinal products sold. The report should contain each product’s international nonproprietary name and trade mark, product’s strength, pack size, quantity of insulin units per package, quantity of packages sold, reference price of full reimbursement, reference price of partial reimbursement, name of healthcare institution, amount eligible for reimbursement for the reporting period. Business entity should submit the relevant report not later than the 5th day of the month following the reporting month, and in December — not later than the 24th day of the reporting month. The reports should be submitted to local budgets holders who have been legitimately assigned for the execution of operating expenses of local budgets for preferential provision of insulin products to diabetic patients defined by the decisions on such expenditures in accordance with the legislation for the reimbursement to business entity of the amount stated in the register within 15 days upon the report receipt.

Moreover, the document amends the CMU Resolution as of March 5, 2014, № 73 "On the Implementation of Pilot Project on State Regulation of Insulin Products Prices" regarding the definition of the unified mechanism of the state regulation of insulin products prices. Thus, the wholesale and retail markups for insulin products should not exceed 10%.

During the pilot project the CMU Resolution as of August 17, 1998, № 1303 “On Regulation of Free and Subsidy Sale of Prescription Medicinal Products in case of Outpatient Treatment of Certain Population Groups and according to Certain Disease Categories” and the CMU Resolution as of October 1, 2008, № 955 “On Stabilization of Medicinal Products and Medical Devices Prices” shall not be applied to insulin products included into the register of reference prices for insulin products.

Please note that formally the pilot project should have been launched on April 1, 2016. The expenses related to insulin products sales should be covered by the operating expenses of local budgets

In order to implement the pilot project the Ministry of Health of Ukraine should negotiate with the Ministry of Economic Development and Trade of Ukraine the calculations of the reference price for insulin products.

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