This Resolution of the Cabinet of Ministers of Ukraine No. 742 dated June 4, 2026, is aimed at optimizing the state program for the reimbursement (cost coverage) of medicinal products. The document introduces systemic changes to pricing mechanisms and price declaration rules, and expands the list of medicines subject to reimbursement. The key objective is to ensure the stability of medicine supplies and the efficient use of budgetary funds through the implementation of a “special reimbursement regime” and the use of letters of guarantee from applicants.
**Structure and Main Provisions:**
The Resolution consists of three sections that amend key regulatory acts in the healthcare sector:
1. **Amendments to Resolution No. 854 (Procedures for Calculation of Prices and Reimbursement):** The algorithms for determining marginal wholesale prices have been improved, the concept of a “letter of guarantee” for confidential pricing has been introduced, and a “special reimbursement regime” has been established to support domestic production and ensure the availability of medicines.
2. **Amendments to the Procedure for Declaring Prices (Resolution No. 439):** Price declaration rules in the National Catalog have been harmonized with prices established under the reimbursement program.
3. **Amendments to the Procedure for Implementing the Program of Medical Guarantees for 2026:** The list of medicinal products (in particular, for the treatment of cardiovascular diseases) has been expanded, and clear clinical criteria for prescribing reimbursed drugs have been defined.
**Key Provisions for Practical Use:**
* **Letters of Guarantee:** Applicants may now submit letters of guarantee, which allows for keeping confidential price information away from the general public, while the National Health Service of Ukraine (NHSU) uses this data exclusively for reimbursement calculations.
* **Special Reimbursement Regime:** This is a mechanism that provides preference to manufacturers performing a full production cycle (or its key stages) in Ukraine, or ensures the availability of medicines at the lowest price if the drug is absent from the list. This limits competition for a specific period (1 year) to stabilize the market.
* **Expansion of the List:** A large list of drugs for the treatment of cardiovascular and cerebrovascular diseases (e.g., prasugrel, ticagrelor, edoxaban, sacubitril/valsartan, etc.) has been added, which will take effect from July 2026.
* **Clinical Protocols:** Stringent conditions for reimbursement have been established for certain groups of drugs (e.g., for dapagliflozin, anticoagulants, or ticagrelor), where reimbursement is possible only if specific medical indications are recorded in the electronic healthcare system.
These changes are [significant/crucial], as they directly affect budgetary expenditures, pricing mechanisms in the pharmaceutical market, and the procedure for providing medical services under the state guarantee program.
