Proposed changes to the system providing insulin have met with a mixed response, and it seems less than clear that those with diabetes would be better off
The Government is planning to change the system for providing diabetics with insulin. At present local authorities buy the medicine and then distribute it to those needing it. The Cabinet of Ministers is proposing to change this system, with diabetics receiving the money directly and being able to decide themselves which specific insulin to buy, how foreign makes differ from Ukrainian ones.
The Minister for Health says that a system has been decentralized for two years in that local state authorities purchase insulin, however this is still bulk buying, not for specific individual with diabetes. He stresses that mechanisms must be developed to ensure that the public are not in a worse position.
The situation in the Lviv region
In the Lviv region around 9 thousand people suffer from sugar diabetes and need daily doses of insulin. They say that they have provisions of the vital medication for 2 months. However Radio Svoboda’s correspondent in the region, Halyna Tereshchuk says that there are problems with purchasing expensive insulin replacements from abroad.
The proposed changes by the Government have received a mixed response from doctors. There are fears that those using Ukrainian medication will receive less funding than those who depend on imported insulin, and that this could lead to disgruntlement among diabetics. They are also concerned that the money could be spent on other needs and the person would remain without insulin.
The mechanisms for implementing the conceptual strategy are also unclear, yet the planned tender at local level for insulin purchases has been suspended because of the proposed changes.
The Head of the City Department of Health Volodymyr Zub assured Radio Svoboda that people would not be left without insulin, adding that the amount allowed for in the planned regional budget is 15-20% higher than last year.
So will the new method work?
Former Deputy Minister of Health Valery Ivasyuk says that the money being proposed for each person with diabetes is scarcely enough for domestically-produced insulin, and this cannot compete on quality with its foreign equivalents. “As well as the fact that these insulins don’t treat the problem, they are also difficult to dose. Not to speak of the fact that our insulins are extremely “dirty” with a lot of things added.”
25-year-old Hanna from Kyiv has had diabetes since her last year at school. She says that the system for providing medication is appalling. “When the government didn’t have any money, we were changed onto Ukrainian insulin. Then they needed populist measures and they changed to the most expensive insulin. Now there’s a financial crisis and there isn’t any again. At the end of the day we’re not talking about toys, but about a living organism that gets used a particular kind of insulin.”
According to Viktor Pomanyuk, Deputy Head of the Board of the one pharmaceutical company in Ukraine that produces a full cycle of insulin, each day 120 thousand diabetics use Ukrainian-produced insulin, this being 60% of all diabetics in the country. He says that there is a fairly strict level of control over quality in Ukraine, and that the high level of competition makes it impossible for just anybody to get on the market.
Valentina Ocheretenko, Chair of the Council of the Ukrainian Diabetic Federation, maintains that there is no such system as the one proposed anywhere in the world. She believes that if the method is implemented, it will be harder for diabetics to obtain medicine. Such person-linked aim would, for example, go through the main savings bank where recently there were huge queues with people trying to get their deposits. “Insulin is not the sort of medicine which you can put off getting. In three days a person dies if s/he doesn’t get it.”
According to the Ministry of Health, there are over 1 million people suffering from diabetes in Ukraine. Of these over 150 thousand cannot live without insulin.
Based on a report by Marichka Naboka and Nadiya Sherstyuk at www.radiosvoboda.org
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