Former Deputy Minister Lisnevska analyzes the healthcare budget: what will change for every Ukrainian in 2025?
27 November 2024 16:34
The draft budget for 2025 provides for almost UAH 211 billion in healthcare spending. Funds have been allocated by 35% more to finance the Medical Guarantee Program, as well as the expansion of the Affordable Medicines program, which will include 15 new drugs. However, will every Ukrainian feel the positive changes, what are the possible challenges associated with the restoration of the medical infrastructure destroyed by the war, and what new rules for disability registration will work after the MSEC reform – all these questions were answered by Natalia Lisnevska, Deputy Minister of Health of Ukraine in 2014-2015, a medical law specialist and lawyer, in an interview with "Komersant Ukrainian".
“Affordable Medicines” in 2025. Patients with what diseases will have access to free medicines?
The budget of the “Affordable Medicines” program for 2025 will amount to UAH 6.6 billion, which will significantly expand its capabilities. As part of this program, it is planned to create new areas for the treatment of diseases such as rheumatology, endocrinology, and neurology. This means that patients who need support in the treatment of these diseases will have access to the necessary medicines free of charge or with a partial co-payment.
In addition, the list of reimbursement will include modern combination drugs for the treatment of cardiovascular diseases, which will increase the effectiveness of therapy for patients with heart problems. The budget also provides funding for the reimbursement of medicines for children, which is an important step to ensure quality treatment for the younger generation.
Procurement of medicines and medical devices
In 2025, UAH 11.8 billion will be allocated for centralized procurement of medicines and medical devices, which is UAH 1.8 billion more than in the current year. These funds will significantly improve the availability of medicines for the population. In particular, for the first time in Ukraine, procurement of medicines and medical devices for patients requiring intensive care is planned. This includes expensive drugs and materials, such as
- consumables for acute dialysis;
- extracorporeal oxygenation;
- modern antibiotics.
Vaccines and the expansion of the vaccination schedule
It is currently difficult to allocate the exact part of the budget that will be used for the purchase of vaccines. However, it is known that additional funds may be needed to meet new needs related to the expansion of the National Vaccination Schedule. In such cases, donor funds or other sources may be attracted in addition to state funding.
The 2025 budget provides over UAH 175 billion for the Medical Guarantee Program. What does this mean for Ukrainians?
Yes, it is almost UAH 17 billion more than this year. This will allow medical institutions to provide free, accessible and high-quality medical care in key areas.
In particular:
- uAH 25.6 billion is allocated for primary healthcare.
- uAH 144.6 billion – for specialized medical care, including:
- uAH 80.2 billion – for inpatient specialized care for adults and children.
- uAH 15.6 billion – for outpatient medical services.
- uAH 11.4 billion – for emergency medical care.
The NHSU has already announced the procurement of 38 packages of medical services for the next year. In 2025, the term of the contract between the NHSU and service providers will depend on the Procedure for Implementation of the Medical Guarantees Program for 2025, the area of medical care and the status of the institution (cluster or supercluster).
These changes will allow medical institutions to plan their revenues in a stable way, which will allow them to update equipment, modernize infrastructure and improve the quality of medical services. This will have a positive impact primarily on patients, who will have access to quality diagnostics and treatment.
The Parliament has adopted the reform of the MSEC system. What will change for people with disabilities?
This is an important step towards creating a transparent, convenient and modern system for people with disabilities. The key changes envisaged by the new system are as follows:
- the possibility of online participation. Patients will be able to participate in MSEC meetings remotely, which will reduce time and money costs;
- remote review of documents. Instead of the mandatory presence of the patient, experts will be able to review their documents remotely;
- integration into the electronic healthcare system (EHS). The results of the MSEC meetings will be entered into the EHR, which will simplify access to data for doctors and speed up decision-making;
- presence of lawyers or authorized persons. Patients will have the right to invite lawyers, authorized representatives or their doctors to the meeting;
- recording of meetings. People with disabilities or their representatives will be able to make audio and video recordings of meetings and take photos of documents;
- clear deadlines for decision-making. The Cabinet of Ministers of Ukraine will set maximum timeframes for MSEC meetings and decision-making;
- an appeal procedure. Persons with disabilities or their representatives will be able to appeal against the MSEC’s decisions on their own;
- improving discipline among MSEC members. In the case of gross violations, the Cabinet of Ministers will determine the grounds for temporary deprivation of membership in the commissions;
- division of the MSEC into levels. The commissions will be clearly organized at the first, second and other levels for more efficient work.
In addition, on November 15, 2024, the Cabinet of Ministers of Ukraine adopted a resolution “On Some Issues of Implementation of the Assessment of a Person’s Daily Functioning“. It changes the traditional MSEC process by introducing a new approach – the assessment of a person’s daily functioning. This process will be carried out by expert teams of doctors at multidisciplinary hospitals. The main goal is to quickly identify individual patient needs and help them return to active life. People with disabilities will have the right to choose the institution where they will be assessed.
As for people who have been diagnosed with a lifelong disability, their status remains unchanged, along with all their rights, benefits and social guarantees. For those whose re-evaluation falls within the period of the new system implementation, the disability is automatically extended for 6 months, along with the corresponding payments.
Are medical facilities fully prepared for power outages?
Power outages in medical facilities are a completely unacceptable situation, as they can directly threaten the lives of patients. Despite regular power outages in Ukraine, key hospitals should be able to operate as usual thanks to the provision of generators.
According to the Ministry of Health, during the war, healthcare facilities received more than 12,000 generators, of which 4,000 were delivered after the start of the full-scale invasion. In addition, 90 hospitals are equipped with solar panels, which allows them to partially cover their energy needs.
Main problems:
- insufficient supply. Not all healthcare facilities have generators or solar panels, although patients need help in each of them. This is especially true for hospitals in remote regions and rural areas;
- lack of budget funds. The budget for 2025 does not provide for the purchase of additional energy equipment (generators, solar panels) or energy efficiency measures;
- problems with fueling generators. The cost of fuel for generators is borne directly by the heads of medical institutions. This creates risks, as hospitals with limited budgets may be forced to choose between purchasing fuel for the generator and financing equipment repairs or other critical needs.
Are funds provided for the construction and renovation of medical facilities?
The draft budget for 2025 allocates UAH 5.6 billion for capital expenditures in the healthcare sector. These funds will be used to modernize and develop medical infrastructure, including the repair and construction of medical facilities, as well as the renewal of equipment. Priority is given to facilities that provide access to critical services.
In addition, under the new Public Investment Management (PIM) system, a total of UAH 224.2 billion has been allocated for the restoration of the country’s critical infrastructure, of which UAH 115 billion will be raised under state guarantees.
What does this mean in practice?
Funding allows us to gradually restore medical infrastructure and provide it with modern equipment. However, a significant part of the process depends on the effective implementation of the planned projects. This includes:
- repair or construction of new hospitals, especially in regions affected by the war;
- purchase of modern diagnostic and treatment equipment;
- providing hospitals with conditions to work in crisis situations (for example, during power outages).
The first year of the PIM system will show its effectiveness and capabilities. Although challenges remain, the funding provided under the 2025 budget and the PIM system is an encouraging step towards modernizing the healthcare infrastructure. This lays the foundation for the development of the healthcare sector in the post-war reconstruction.
Author – Anastasia Fedor
