Chronic Obstructive Pulmonary Disease (COPD) is an actual problem for healthcare systems in different countries taking in account it`s high morbidity, mortality, impact on quality of life and related costs. COPD in Ukraine could be one of the most valuable medical and socio-economic problems as for developing country, the human capital affected by COPD is the most important national asset. The access to drugs is critical especially for COPD patients, medications for basic therapy are very expensive, while intended for use permanently. This study was performed to investigate the status with COPD in Ukraine and determine possible ways for improvements and developments in COPD management and related processes in healthcare system in Ukraine. The following areas were investigated: epidemiological data, data in COPD management, health economics data and targeted literature review. Results showed that very limited epidemiological COPD data are available in Ukraine. There are favorable conditions for good COPD management in Ukraine because of availability of the adopted guidance and the unified clinical protocol that cover prophylaxis, diagnostics, treatment and rehabilitation of COPD patients. Ukrainian clinical guidance in COPD management has external validity and is expected to be updated on regular basis. There were several country-specific Health Economic studies focused on COPD but these studies have limitations due to substantial assumptions and extrapolations from small to large populations. More Health Economics large-scale studies needs to be performed in Ukraine. Results of current study, also, showed that COPD is a relevant topic for pulmonology research in Ukraine.

Background. Health technology assessment (HTA) introduction and implementation for development of the National List of Essential Medicines (NLEM) took place in Ukraine in 2016 in the context of National Drug Policy until 2025. The study aimed to outline the reimbursement of medicines for asthma treatment, market access for innovative medicines, main steps of HTA development in the decision making process in Ukraine in line with the international requirements and future directions. Methods. Literature review was conducted examining legislation database and scientific publications on the study issues in Ukraine: epidemiology of asthma, reimbursement programs, HTA development, affordability of innovative medicines for asthma treatment, market analysis. The study was performed to investigate the practices, processes and policies of value assessment and their impact in Ukraine. Results. In 2016 a legal framework was developed for the elaboration of NLEM and procedures for reference pricing and reimbursement programs. HTA is used for the inclusion medicines on the list based on the applied evidence of quality, efficacy, effectiveness, safety and economic evaluations adhering to the Order of Ministry of Health (MoH). HTA implementation in 2016 consisted of legislation, HTA training for experts of Expert committee of MoH and development of NLEM. Reimbursement programs for cardiovascular diseases, type 2 diabetes (T2D), asthma have started in April 2017 due to the adopted regulations. Conclusions. HTA use in the decision-making in Ukraine will provide an access to innovative medicines for patients and transparent, consistent decision making process in assessing the health technologies for inclusion on regulatory lists and reimbursement programs.