The structural analysis of government expenditures on the purchase of antituberculous drugs

Abstract

The aim. To conduct a structural analysis of the volume of government spending on the purchase of antituberculosis drugs (anti-TB D) within 2014–2018.
 Materials and methods. In the study, we used information on public procurement of anti-TB D for 2014–2018 presented on the website of the Ministry of Health of Ukraine in the section “Procurement of Medicines”, as well as statistical data of the “Center for Public Health of the Ministry of Health of Ukraine” on the incidence of multi-drug resistant tuberculosis (MDR-TB) in the population.
 Analytical and comparative, system, and logical methods, as well as economic analysis were used. With the help of synthesis the conclusions and recommendations were formed.
 Results. It was found that in 2014-2018, the MDR-TB incidence rate increase had a positive dynamics in reducing the number of registered cases. For example, in 2015 this indicator was 2.56 %, and in 2018 it was -7.93 %.
 It was proven that public procurement of anti-TB D in physical terms was chaotic. Thus, in 2015/2014, the growth rate of anti-TB D number was 35.55 %, in 2016/2015 – -31.59 %, in 2017/2016 – 15.31 %, in 2018/2017 – 6.13 %. It was found that the dynamics of the growth rate of purchases of TB D in the national currency and USD had some differences. For example, in 2015, expenses increased by 55.02 % in the national currency, while in dollar terms this indicator decreased by 15.64 % compared to 2014. At the same time, in 2018 there was a positive trend of increasing the volume of public spending in monetary terms. Thus, in 2018, the growth rate in the national currency was 53.16 %, and in USD – 49.83 %.
 It was found that in the structure of public spending there was a tendency for an insignificant predominance of foreign anti-TB D. Based on the comparative analysis of government spending on groups of anti-TB D by the priority of their use in treatment regimens according to the standards it was determined that the process of anti-TB D purchasing did not meet the priority criteria for treatment. It complicates the implementation of the process of reforming TB care in connection with the construction of an outpatient model.