For the fourth year in a row, the Ukrainian healthcare system has been operating in conditions of full-scale war, balancing between the need for urgent response to crises and the implementation of systemic reforms. 2025 was a period of contrasts, where a historic increase in the budget for the purchase of medicines was accompanied by critical logistical problems and legislative conflicts. The Patients of Ukraine Charitable Foundation summed up the year by analyzing the real state of access to treatment, the effectiveness of public spending, and new challenges facing the patient community.
Financial breakthrough and new horizons for procurement
The situation with drug supply at the beginning of 2025 looked threatening, as the allocated UAH 11.8 billion covered only 60% of the actual need. However, thanks to the joint efforts of patient organizations, parliamentary committees, and the Ministry of Finance, an unprecedented result was achieved—in the middle of the fiscal year, funding was increased by an additional UAH 3.1 billion. This made it possible to raise the level of provision to 75% and enabled the state-owned enterprise Medical Procurements of Ukraine to contract more than 400 additional items. These included essential drugs for the treatment of cardiovascular diseases, hemophilia, oncology, multiple sclerosis, and primary immunodeficiencies.
A significant step forward was the signing of managed access agreements with leading global manufacturers. For the first time, the state is purchasing innovative drugs. This opens up access to free modern treatment for patients with breast cancer, acute lymphoblastic and myeloid leukemia, who previously could not afford such therapy due to its extremely high cost.
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Transformation of the reimbursement program
The Affordable Medicines Program has shown significant growth over the year. The list of drugs has expanded by almost 20% and now includes 705 brand names. The list now includes, for the first time, drugs for hormone therapy for breast cancer and drugs for the prevention of anemia in pregnant women. The list of insulins and test strips for patients with type I diabetes has also been updated, although the issue of providing for patients with type II diabetes remains open — about 1.3 million Ukrainians are still waiting for the necessary test strips to be included in the reimbursement program.
Since July 2025, physical access to medicines has also been simplified: patients can now pick up their prescriptions at any pharmacy that has signed a contract with the National Health Service of Ukraine. This innovation has made life much easier for residents of remote regions by reducing travel costs and waiting times. A strategic course has been set to expand outpatient treatment for cancer patients and patients with pulmonary hypertension, which should reduce their dependence on hospitals and centralized supplies.
Quality versus quantity in rehabilitation
The network of rehabilitation facilities continues to grow: the number of service providers has increased to 554, and the number of physical therapists has reached 3,500. Despite the positive dynamics, Ukraine still lags significantly behind European indicators in terms of the number of specialists per capita. A key event of the year was the approval of the first state standard for rehabilitation in cases of spinal cord injury, which is the foundation for unifying the quality of services. Next in line are standards for the treatment of strokes and amputations.
An important breakthrough was the requirement for rehabilitation specialists to be included in teams working with stroke patients. This allows patient recovery to begin during the acute phase, preventing complications. At the same time, Ukraine’s first master’s program in speech and language therapy was launched, aimed at addressing the acute shortage of specialists to work with veterans and civilians who have communication impairments after trauma.
The dark side of supplies and legislative barriers
Positive developments are overshadowed by the activities of unscrupulous suppliers. According to the patient community, in 2025, Deutsch-Pharm disrupted 12 deliveries, the vast majority of which concerned drugs for cancer patients. The situation is complicated by attempts by certain political forces to amend the legislation to allow suppliers to independently replace drugs with “similar” ones if they are unable to fulfill the contract. Such initiatives have been blocked, and the state-owned company Medical Procurement of Ukraine is currently developing mechanisms for strict sanctions and restrictions on the participation of violators in future tenders.
The issue of access to medical cannabis remains unresolved. More than 6 million patients with PTSD, epilepsy, and chronic pain cannot receive treatment due to legislative restrictions on the import of raw materials, which will remain in effect until 2028, and the lack of domestic production.
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Registration crisis and medical migration
The limited size of the Ukrainian public procurement market does not encourage global manufacturers to register new drugs in Ukraine. This leads to the phenomenon of “medical tourism,” where patients with rare diseases such as achondroplasia or Wilson’s disease are forced to seek treatment abroad or on the black market. The cost of unregistered drugs can reach thousands of euros per month, making treatment inaccessible to most families. For example, innovative treatment for bone growth in children, available in the EU, remains outside the legal framework of Ukraine, leaving patients with only traumatic surgical alternatives.
Financial outlook for 2026
The state budget for next year provides for an increase in healthcare funding to UAH 258.6 billion. The growth in spending on the Medical Guarantees and Reimbursement Program gives hope for the stability of basic services. At the same time, the UAH 15.2 billion allocated for centralized procurement covers less than 60% of the projected need of UAH 26 billion. This means that without additional funding, expanding access to innovative medicines will be significantly limited.
The initiative to introduce large-scale screening for people aged 40 and over, for which UAH 10 billion has been allocated, remains controversial. Experts emphasize the importance of early diagnosis of cardiovascular diseases, but express reservations about the effective use of these funds and the readiness of primary care to handle such a workload. The priorities of the patient community for the coming year remain advocacy for full funding of purchases, acceleration of drug registration, and the creation of effective supervisory boards at medical institutions.
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