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In 2017, the Verkhovna Rada adopted the law “On state financial guarantees of medical care for the population”. Subsequently, a new body was created – the National Health Service of Ukraine, which is responsible for one of the key elements of the reform – financing the healthcare system.

Based on the best international experience and proven practices of other countries, a public procurement service for medical services was established in Ukraine.

“From year to year, we are actively working to provide high-quality, affordable and free medical care to Ukrainian patients. We implement the best international practices and state-of-the-art experience of other countries. Gradually, we are moving forward. A full-scale war did not slow us down, but rather accelerated us. I am sure that it is the changes that are being implemented that allow us to survive in this difficult time. It is worthy to maintain a medical front and provide medical care, despite all the circumstances, challenges and conditions. I am sincerely grateful to the National Health Service for the work that they systematically carry out to improve the medical sector, for the adaptability to constantly new challenges that they demonstrate. We have something to be proud of. I wish you not to stop and do everything together to make the healthcare system better,” said Viktor Liashko, Minister of Health of Ukraine. 

During these 5 years, the state has implemented a number of changes aimed at providing high-quality and affordable medical services. The state budget pays for medical services that are provided to patients, not beds kept in hospitals (money follows the patient), Ukrainians have the right to choose a primary care doctor, medical institutions have received more managerial freedom and the ability to use resources more efficiently, and the introduced program of medical guarantees provides for the list and volume of medical services and medicines that the state guarantees to the population, giving patients a financial fulcrum during treatment. 

The National Health Service constantly analyzes the needs of citizens in medical services, contracts those medical institutions that are able to provide safe and high-quality care. 

“We are grateful for the partnership and patient orientation of every medical and pharmacy employee who faithfully performs their duties during this difficult time. We are grateful to representatives of local and central authorities, heads of healthcare institutions for their concern for the development of medicine in communities. We are grateful to our international partners for their support and cooperation,” said Natalia Husak, head of the National Health Service of Ukraine.

Due to the administration of the NHSU, the Affordable Medicines Program, pharmacies receive funds for released medicines on time and transparently. The reimbursement program significantly reduces the financial burden for Ukrainians and ensures uninterrupted access to medicines for patients with chronic diseases. In 2019, the reimbursement program provided for reimbursement of funds for 258 drugs (cardiovascular diseases, bronchial asthma, type II diabetes), in 2023 for 435 drugs. During this time, drugs for the prevention of strokes and heart attacks, insulins, drugs for mental and behavioral disorders, epilepsy, Parkinson's disease, chronic obstructive pulmonary diseases, immunosuppressive drugs, etc. were added.

At the beginning of the reform (2018), only 538 municipal institutions, of which 45 private and 37 doctors - sole proprietors, signed a contract with the NHSU for the provision of primary health care. Today (2023) the number of municipal institutions who signed a contract has more than doubled – 1276, of private institutions has increased sevenfold – 328, and of sole proprietors has increased twenty times– 747.

For all medical institutions with which the NHSU has a contract, there are uniform tariffs and transparent payment terms, regardless of the form of ownership, location and other factors.

The program of medical guarantees, which began to operate in full in 2020, had at that time 31 packages (primary, specialized, palliative care, rehabilitation). With the development of the program, packages for treatment and vaccination against COVID-19, support of patients with tuberculosis in primary care, one-day surgery, neonatal screening, etc. were added. In 2023, the program contains 41 packages, including packages for institutions in the territories of military operations and occupied territories.