Aim. To conduct the clinical and economic analysis of the state of pharmaceutical provision of patients with dementia in Alzheimer’s disease in Ukraine. Materials and methods. Both general theoretical (historical, analytical-comparative, systemic, graphical, logical, hypothetical-deductive) and applied (clinical-economic, mathematical-statistical) research methods were used. Results. It was found that the vast majority of patients belonged to socially unprotected segments of the population. Thus, the proportion of pensioners was 71.0 %, and 40 patients (20.0 %) had disability groups. All patients, without exception, had a burdened anamnesis. On average, patients were treated in specialized medical institutions for 43.8 bed-days. The sum of 548,714.5 UAH (19,072.45 USD) was spent on drug provision for these patients, which amounted to 2,743.57 UAH (95.36 USD) per one patient. For one bed-day, patients used drugs for only 62.64 UAH (2.18 USD). Physicians wrote 2,487 prescriptions (12.4 per a patient) and used 128 drugs under international non-proprietary names or 218 drugs taking into account all their trade names. In the structure of medical prescriptions, there was a significant duplication of drugs represented by international non-proprietary names. According to the first level of the ATC classification system, the highest rates of prescription frequency were for group N – Drugs affecting the nervous system (861 prescriptions or 34.62 %), and according to the second level, there were drugs from group C01 – Cardiac therapy group (375 prescriptions or 15 .08 %). At the same time, the second and third positions by the number of prescriptions were occupied by drugs from groups N05 – Psycholeptics (363 prescriptions or 14.60 %) and N06 – Psychoanaleptics (309 prescriptions or 12.42 %). It was found that physicians prescribed 617 (24.81 %) drugs recommended by the Clinical Protocol for the treatment of cognitive and non-cognitive behavioral disorders in patients with dementia due to Alzheimer’s disease. Of the drugs in group N06D – Anti-dementia drugs, the drugs in group N06DX – Other drugs for the treatment of dementia had the highest prescribing rates (191 physicians), while drugs of group N06DA – Cholinesterase inhibitors were prescribed by physicians only 43 times. The highest prescription rates in the structure of pathogenetic therapy were drugs of group N06DX01 – Memantine (188 prescriptions or 30.47 %). Then, drugs of group N06DA03 – Rivastigmine (34 prescriptions or 5.51 %) and N06DA02 – Donepezil (6 prescriptions or 0.97 %) followed by a significant margin. The drugs of group N06DX01 – Memantine also occupied leading positions in the structure of drug consumption. Thus, the volume of their consumption was equal to 84,420.2 UAH (2,934,314 USD), which accounted for 15.39 % of the total cost of drug provision for patients and 91.76 % of drug consumption in group N06D – Medicines for use in dementia. Conclusions. A significant financial burden associated with the need to use pathogenetic therapy drugs in patients with dementia in Alzheimer’s disease requires the development and implementation of effective models of resource provision for pharmacotherapy and social support of neuropsychiatric patients in Ukraine.

The aim: to assess the state of pharmaceutical provision of patients with dementia in Alzheimer's disease in Ukraine in accordance with international recommendations. Materials and methods. In our studies, we used data from international guidelines, clinical protocols that regulate the organization of medical and pharmaceutical care for these patients in the USA, Australia, Japan, Germany, Great Britain, Finland, India, Kazakhstan, and Ukraine. The actual state of pharmaceutical provision of these patients in Ukraine was studied using a depersonalized database of medical prescriptions, which operates based on a number of specialized healthcare institutions. In addition, data from the Morion information search system were used. We used general theoretical (historical, formal, graphic, hypothetical-deductive, etc.) and applied (clinical-economic, organizational-economic, mathematical-statistical, etc.) research methods. Results. It has been established that a consolidated opinion has been formed in the world scientific community regarding the possibility of effective use in the pathogenetic treatment of patients with dementia in Alzheimer's disease of drugs from the groups N06DA Acetylcholinesterase inhibitors and N06DX-Other drugs for use in case of dementia. Thus, the pharmaceutical component of international recommendations, clinical protocols for the treatment of patients with dementia in Alzheimer's disease contains four drugs used in pathogenetic therapy. These are N06DA02 Donepezil, N06DA03 Rivastigmine, N06DA04 Galantamine and N06DX01 Memantine. It has been reported that all the above drugs are included in the domestic clinical protocol for the treatment of patients with dementia in Alzheimer's disease, the State Drug Formulary (with the exception of N06DA03 Rivastigmine), and the State Drug Registry. At the same time, all of them were absent from the National List of Essential Drugs, which has an important socio-economic and medical-pharmaceutical significance in the health care system. It was found that patients (200 people) received 2487 prescriptions (100.0 %), among which 9.41 % (234 prescriptions) were drugs used in pathogenetic treatment. There is a highly disproportionate nature of the distribution of prescriptions and consumption by international generic names of drugs. Thus, drugs N06DX01 Memantine accounted for 80.41 % (188 prescriptions) of all prescriptions in the group N06D Drugs for use in dementia, and the consumption rate was UAH 84420.20, which accounted for 91.48 % of the amount of expenses directed to patients with carrying out pathogenetic treatment. Significant dominance of drugs N06DX01 Memantine in the structure of prescriptions and consumption indicates the presence of severe, advanced forms of dementia in patients. This fact once again emphasizes the need for early detection and treatment of cognitive impairment, primarily for the rational use of limited health care resources. We have found that there are no prescriptions for N06D A04 Galantamine preparations, which are recommended by the relevant international recommendations in different countries of the world, as well as by the domestic clinical protocol for the pathogenetic treatment of mild and moderate forms of Alzheimer's disease. At the same time, N06DA05 Ipidacrine preparations were used in the treatment of domestic patients, which are not presented in the pharmaceutical component of international recommendations and protocols governing the pathogenetic treatment of the above-mentioned groups of neuropsychiatric patients. Conclusions. The peculiarities of the formation of the pharmaceutical component in the organization of the treatment process of patients with dementia in Alzheimer's disease in Ukraine, established by us, allow further research on the development of rational ways of resource provision of neuropsychiatric patients

The aim: to conduct a comparative analysis of HIV morbidity in Ukraine and in some countries of the European region over the years and to determine the characteristics of the epidemiological situation on this pathology. Materials and methods. The object of the study was HIV incidence data presented on the website of the WHO European Health Portal (1990–2018) and in the Annual Report of the European Center for Disease Prevention and Control and the WHO Regional Office for Europe on HIV/AIDS Surveillance in Europe (2010–2019). Historical, analytical-comparative, systemic, graphic, logical, hypothetical-deductive, mathematical-statistical, epidemiological and other research methods were used. Results. It is established that during 1990-2018 in the group of reference countries only for Ukraine and Belarus there was a significant fluctuation in the incidence rates presented in absolute data. In all countries except Romania, the number of HIV-infected in 2019 was higher than in 1990 (Ukraine, Belarus, Poland) and in 1993 (Germany). Analysis of the dynamics of the absolute number of HIV-infected persons by indicative years (1993, 1999, 2004, 2010, 2016, 2019) allows us to assert the different nature of changes in epidemiological data by group of reference countries. Only in Poland we saw a gradual increase in data for 1993-2019. In all other countries, there was a complex nature of changes in morbidity. According to the analysis of HIV incidence, presented in relative terms, it was found that they ranged in the largest range in Belarus, namely from 11.3 (2010) to 26.1 (2017). Belarus typically had the highest mean chain growth/decline rates of HIV incidence (1.09). In turn, the lowest value of these coefficients was observed in the EU as a whole (0.97). Comparison of average values of HIV incidence per 100 thousand population suggests that in Ukraine this figure was 1.85 times higher than in Belarus, 11.36 times higher than in Poland, 8.65 times higher than in Romania, 10.27 times higher than in Germany and 5.88 times more than in the EU group. Conclusions. The presence of a complex and tense epidemiological situation with HIV infection in Ukraine in comparison with other countries of the reference group of countries suggests the need to implement comprehensive programs to counter the spread of this socially dangerous infection and introduce models for the rational use of limited health care resources and international funds

Annotation. Introduction. Decentralization of power requires the creation of united territorial communities, which should develop strategies for their own development, with the main directions of society development, tasks, prospects for improving the quality of life of the residents of community. In conditions of fierce competition for investment resources, territorial communities, are united, while developing strategies, they must show the peculiarity of their community – local identity, which is the basis for positioning each community. Purpose. The purpose of the article is, monitoring strategies for the development of united territorial communities in the context of the use of identification tools on the example of Kharkiv region. Results. To assess the impact of strategy results on life communities should constantly monitor the effectiveness of implemented programs and projects. The article monitors the development strategy of the united territorial communities of Kharkiv region and identifies the features of each community that must be taken into account in conditions of fierce competition for investment resources, as well as identifies tools to form a positive image of united territorial communities Conclusions. The region has a fairly good education rating of the united territorial communities, which was influenced by the high rates of their population. All the communities of the Kharkiv region, which have been functioning for more than one year, have a stable growth of the resource base, and the vast majority of them do not receive subsidies, on the contrary, they pay a significant reverse subsidy. At the same time, they are also characterized by an increase in the share of expenditures for the maintenance of the management staff in financial resources and a sharp dynamics of capital expenditures, which does not correlate with the growth of budget revenues. At the same time, they are also characterized by an increase in the share of expenditures on the maintenance of the management staff in financial resources and abrupt dynamics of capital expenditures, which does not correlate with the growth of budget revenues. Based on the results, the main identification tools are identified, namely area, population (including demographic structure), income and expenditure level, financing structure, structure of business entities by type of activity and income level, number of social infrastructure facilities, the level of employment and unemployment in the community, the share of agricultural land in the region; the number of enterprises in the region by type of activity; unique name; minerals; the share of certain industries in the region; favorable conditions for tourism development (green, medical, hunting, etc.). The definition of these instruments is the basis for assessing the socio-economic development of society, investment attractiveness. Keywords: united territorial community; strategy, monitoring; tools; identification.