A trip to the pharmacy for many Ukrainians turns into a real test. Pensioners compare prices with the size of their pensions, low-income families postpone treatment until “better times”, and those who do not have money for medicine are forced to rely on luck, folk methods and psychics on social networks. Prices are rising inexorably, imported drugs are becoming financially unaffordable for many, and the shortage of vitally important cheap medicines is no longer surprising. The pharmaceutical market has long operated according to its own rules, where the logic of prices is often inexplicable, while government regulation resembles an imitation of turbulent activity.
For many years, the authorities were silent about it, hiding the problem behind statistical reports and vague promises. At the same time, pharmacies continue to raise prices, pharmaceutical companies dictate their terms, and people survive as best they can. And so, finally, Volodymyr Zelenskyi spoke about it. The statement, which should have been made yesterday, was made only now. But does this mean that the situation will change?
Statement by the President on drug prices and initial reactions
The President of Ukraine, Volodymyr Zelenskyy, called drug prices “absolutely inadequate” and announced consideration of this issue at a meeting of the NSDC. It is about the development of specific measures that should ensure a decrease in the cost of medicines. Despite the fact that the need to control pricing in the pharmaceutical sector has been talked about for a long time, only now is the government officially recognizing the criticality of the situation.
The increase in drug prices is taking place against the background of general inflation, which in 2024 reached 12%. At the beginning of 2025, the tendency to increase in prices did not decrease, which became one of the arguments for raising the NBU discount rate to 14.5%. Such macroeconomic factors affect the formation of prices in the pharmaceutical market, but the cost of drugs often exceeds the level that can be explained only by inflationary processes.
In response to the statement of the head of state, the five largest pharmacy chains signed a declaration on the availability of medicines. It was joined by “9-1-1 Pharmacy”, “We Wish You Health”, “ANC Pharmacy”, “Good Day Pharmacy” and “Traveller”. The declaration will enter into force on March 1 and provides for a proportional reduction of mark-ups by all market participants – from manufacturers to pharmacies.
National manufacturers received an offer to reduce the retail prices of all registered medicinal products, focusing on the level that was relevant on January 1, 2025. In turn, distributors must reduce wholesale prices accordingly by applying proportional discounts to their markup. Pharmacies also undertake to lower retail prices, synchronizing them with reduced purchase prices.
The signatories of the declaration assure that such a scheme will make it possible to achieve a cumulative reduction in the cost of domestic medicines for end users. In addition, they undertake not to allow hidden price increases or manipulation of supply patterns that could nullify the agreements reached. Openness to cooperation with antimonopoly authorities is also declared, which should prevent possible abuses in the market.
However, despite the formal positive rhetoric, the question of actual implementation of the agreements remains. Market participants have repeatedly found loopholes to circumvent regulations, which indicates possible risks this time as well. Whether this declaration will be a real change or another declarative initiative will become clear in the coming months.
What is happening now
For the sake of justice, it should be noted that the “Affordable Medicines” program operates in Ukraine, which is designed to provide citizens with the opportunity to receive essential medicines on preferential terms. The main idea behind this initiative is for the state to cover part or all of the cost of certain drugs for the treatment of chronic diseases, such as cardiovascular disease, bronchial asthma, and type II diabetes. However, the program is not comprehensive and has a number of significant limitations.
One of the key drawbacks is that patients still have to pay extra for most drugs, even if they are on the reimbursement list. State compensation covers only the basic variants of drugs, and if the patient needs a more effective or familiar analog, he must pay the difference. This is especially true for people who have been taking certain medications for a long time and cannot change them due to medical indications or side effects.
Another problem is the limited list of drugs covered by the program. It does not cover a wide range of cheap but critical medications that are used daily by patients with other chronic diseases. In addition, not all pharmacies participate in the program, which creates additional difficulties for residents of remote regions and rural areas, where access to pharmaceutical services is already problematic.
Resolution of the Cabinet of Ministers of Ukraine dated December 24, 2024 No. 1503, the Procedure for the Implementation of the Program of State Guarantees of Medical Services of the Population in 2025 (Program of Medical Guarantees) was approved, which significantly expanded the list of medicinal products subject to reimbursement. UAH 6.6 billion has been earmarked for the implementation of this initiative, which can potentially improve patients’ access to medicines. However, the question of how effectively these funds will be distributed and whether this will affect the real reduction in the cost of medical treatment for Ukrainians remains an open question.
Now in Ukraine, the disease is becoming synonymous with a sentence, not only because of the difficulty of diagnosis or the lack of medical specialists, but also because of the complete financial inability of people to pay for treatment. Patients face unsustainable costs for drugs, operations and rehabilitation, and the state, despite loud statements, provides only a minimal percentage of needs. As a result, thousands of people are forced to either remain without medical care or turn to benefactors and relatives in a desperate attempt to raise funds. But not everyone can do it.
For the majority of seriously ill people, even basic operations remain inaccessible. In public hospitals, patients have to buy anesthesia, suture material, antibiotics and post-operative drugs themselves. This turns any surgery into a financial ordeal. If there is no money, then the patient is simply forced to wait for a “miracle” or die at home. The situation is especially critical for those who need urgent operative intervention – because an ordinary person simply does not have the resources to quickly collect tens of thousands of hryvnias.
Things are going even worse with rehabilitation. After complex operations or severe illnesses, patients often require long-term care, special procedures, medications, and often auxiliary equipment. The state does not compensate for these costs, so rehabilitation becomes a luxury that individuals can afford. While in developed countries people after strokes or operations return to normal life thanks to comprehensive treatment, in Ukraine many simply live out their days in terrible conditions due to lack of proper support.
This problem is especially acute among cancer patients. It should be noted that Ukraine occupies the second position in Europe in terms of the rate of spread of oncological diseases, and the incidence of cancer in Ukraine has increased in recent years. Malignant neoplasms remain among the five main causes of death, second only to cardiovascular diseases. Experts predict an increase in the number of oncological diseases in the coming years. War has a negative impact on the environment, which leads to deterioration of health and quality of life. Explosions, fires, and demolition of rubble can release dangerous carcinogens into the air, soil, and water, including asbestos dust.
As part of the Medical Guarantee Program, more than UAH 6.4 billion has been allocated for the treatment of oncological diseases in Ukraine in 2025, and a new procedure for screening and early diagnosis of cervical, breast and colorectal cancer has been introduced. According to the Ministry of Health, services for early detection and treatment of oncology are free, and the number of medical institutions providing such services is 113.
From the allocated budget, UAH 2.4 billion is allocated to chemotherapy treatment, UAH 2.75 billion to radiological therapy, and more than UAH 1.2 billion to the treatment and support of patients with hematological and oncohematological diseases. In addition, more than UAH 2 billion is provided for the purchase of medicines, medical products and transplantation of hematopoietic stem cells. At the same time, the Ministry of Health emphasizes the importance of early diagnosis of cancer as a key priority of the health care system, which should ensure higher efficiency of treatment and increase the chances of patients’ recovery.
However, despite these statements, even basic chemotherapy or radiation therapy costs Ukrainians huge sums, and innovative treatment methods are an almost unattainable luxury. The state purchases some drugs, but they are often not enough for everyone, and expensive drugs have to be purchased independently. As a result, many patients stop treatment due to lack of funds and simply die. Cancer patients in Ukraine face unsustainable costs for treatment, despite state guarantees and support programs. According to the data of the conducted research, only 1% of patients were able to receive surgery free of charge. The rest were forced to pay surgeons, nurses, buy drugs for anesthesia, resuscitation and the postoperative period. This means that the system actually puts the financial burden on the patients themselves, leaving them alone with their problems.
Somewhat smaller but still significant costs are borne by patients undergoing chemotherapy and radiological treatment. Although the provision of chemotherapy drugs has improved, 53% of respondents still purchased at least some of the necessary drugs at their own expense. Even in cases where drugs are formally procured by the state, patients are forced to spend large sums on concomitant medications and treatment of complications.
The average cost of cancer treatment reaches 120,000 hryvnias. But if we are talking about modern methods of treatment, such as targeted and immunotherapy, then the situation becomes critical. These methods are needed by 26% of respondents, but only 5% receive them free of charge, another 26% receive them partially. The worst thing is that 12% of patients are forced to refuse treatment due to lack of funds. They simply cannot afford the therapy that could save their lives.
Patients are forced to find funds in any possible way. Only 3% of cancer patients who need innovative therapy have personal savings for treatment. 21% sell property, take loans or borrow money. 28% are forced to raise funds publicly through charity campaigns. In most cases, the financing of treatment falls on the shoulders of family, friends and colleagues. The state practically distanced itself from the problem, leaving cancer patients alone with financial difficulties.
The most necessary drugs for cancer patients are Trastuzumab and Bevacizumab. The former is purchased at public expense, while the latter remains financially out of reach for many patients. The cost of the annual course of “Bevacizumab” is 783 thousand hryvnias, of which 51,224 hryvnias is VAT, which only adds to the financial burden. This drug is used to treat various forms of cancer, including ovarian, cervical, lung, and colorectal cancer. But the state does not provide it to everyone who needs it.
After completing the main treatment, 40% of patients need hormone therapy, but 47% of them buy it at their own expense, and another 31% only receive it periodically from the state. Some patients do not even know that they can get hormonal drugs free of charge. Doctors do not always inform about this possibility or refuse to write the corresponding prescriptions. As a result, cancer patients are not only forced to fight the disease, but also spend their energy on finding funds, knocking on the thresholds of hospitals and turning to volunteers and charitable foundations for help. So, the system, which should protect people, works not for the patient, but against him. Government programs provide only minimal assistance, and those unable to pay are often left with no chance of recovery.
We would like to believe that the government’s statements about reducing drug prices will finally turn into real actions. However, this raises serious doubts, because the pharmaceutical market in Ukraine is a highly profitable business, where money always has more weight than people’s needs. It is unlikely that major market players will voluntarily go to a significant price reduction, especially in conditions of economic instability. While the issues are being resolved, Ukrainians face a choice between life and money every day. Someone is forced to sell property, take loans or organize public fundraising, and someone simply refuses treatment.
Lack of access to cheap medicine and medical care has become the norm here, while mortality statistics are increasing not only due to diseases, but also due to the economic inability of society to fight for its own health. And while officials discuss initiatives and pharmaceutical companies sign declarations, Ukrainians continue to survive, counting every penny before entering a pharmacy.
