Country work

WHO/Samvel Azatyan

2017- Kyrgyzstan

Promoting good governance in Kyrgyzstan’s pharmaceutical system

WHO continued to support Kyrgyzstan on the reform and regulation of the national pharmaceutical sector. A study tour to Estonia for Kyrgyzstan’s Members of Parliament and other government officials took place to help understand better how efficiency in medical product regulation can be achieved and to enrich the collaboration between representatives from different governing institutions.

Training in benchmarking for the National Medicines Regulatory Authority

WHO trained 25 staff of the National Medicines Regulatory Authority in benchmarking medicines and medical products against WHO norms and standards, to ensure that health products are regulated consistently and to eliminate substandard and falsified medicines. The workshop guided participants on computerized benchmarking tools and established a roadmap for the process in the country.

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2016 - Kyrgyzstan

Support for the regulation of pricing and reimbursement of outpatient medicines in Kyrgyzstan

WHO/Europe has been working with the Ministry of Health of Kyrgyzstan on the reform and regulation of their national pharmaceutical sector. A country analysis, commissioned by WHO/Europe in 2016, examined the causes of high out-of-pocket payments for prescription medicines in Kyrgyzstan and presented options to address the problem through policy reform. Recommendations to control and reduce high out-of-pocket payments included putting in place price regulation for medicines publicly reimbursed by the Kyrgyz health insurance fund, regulating retail sector margins, updating legislation on the criteria and processes for adding or removing medicines from the list of reimbursed medicines, and improving data collection on reimbursement prices.

Support for reviewing Kyrgyzstan’s National Essential Medicines List

WHO/Europe provided technical assistance to the Ministry of Health of Kyrgyzstan for updating the National Essential Medicines List (NEML), and worked with members of the national expert group appointed to conduct this review. The expert group reviewed discrepancies between the 2015 WHO Model List of Essential Medicines and Kyrgyzstan’s 2012 NEML, and suggested revisions for consideration by the Minister of Health.

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2016 - Estonia

Assistance to increase the availability of medicines in Estonia

WHO/Europe supported a study to identify possible barriers to increasing the availability of medicines in Estonia and to suggest options to overcome them. The analysis included a review of relevant national and European Union (EU) legislation regulating the marketing of pharmaceuticals, as well as local practices related to pricing, reimbursement and procurement. WHO/Europe and Estonia also continued their work on the development of the clinical guideline process, which has been a priority in WHO’s collaboration with Estonia for more than 5 years.

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2016 - Republic of Moldova

Support for strengthening the legal framework of the pharmaceutical sector in the Republic of Moldova

At the request of the Ministry of Health of the Republic of Moldova, WHO/Europe is supporting the country’s move to align its pharmaceutical legislation and practice with respective EU acquis communautaire, or obligations of membership. The Government of the Republic of Moldova has expressed a strong political desire to achieve EU membership, which necessitates this alignment process. WHO/Europe organized a series of 3 seminars on key aspects of pharmaceutical regulation in the EU, aimed at increasing the capacity of staff of the Ministry of Health, the Agency for Medicines and Medical Devices, the National Health Insurance Company and the State Medical and Pharmaceutical University to support the necessary legislative changes.

Help with increasing access to hepatitis C medicines in the Republic of Moldova

WHO/Europe also supported the Republic of Moldova in increasing access to new hepatitis C medicines. In collaboration with WHO headquarters in Geneva, Switzerland, the health technologies and pharmaceuticals programme conducted a rapid assessment of the patent status for hepatitis C medicines in the country, and concluded that the patent rules allow for the import and use of generic versions of these medicines. The programme also facilitated contact with a manufacturer of generic medicines for hepatitis C to foster their import to the Republic of Moldova.

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2016 - Ukraine

Support for the development of Ukraine’s national medicines policy

In 2015 and 2016, WHO/Europe and partners consulted with the Ukrainian Ministry of Health on revising the processes and systems for the selection, financing, procurement and use of medicines in the country. In January 2016, the Ministry of Health circulated the terms of reference for 9 working groups that would contribute to developing the national medicines policy. Each group focuses on an aspect of the pharmaceutical sector, such as regulation, reimbursement, financing or responsible use. Through the health technologies and pharmaceuticals programme, WHO/Europe supported and advised the working groups during their discussions. The Ukrainian Government is continuing to develop a policy and strategy based on input from national stakeholders, and is expected to complete work in this area in 2017.

In 2016, other major activities included:

  • supporting the development of an outpatient medical devices reimbursement scheme in Albania;
  • providing technical assistance for the development of health technology assessment (HTA) capacity in Greece, including a study visit to Portugal for Greek policy-makers on 6–8 July 2016 to provide an overview of a well-established HTA agency in a European country of comparable size and with similar economic, social and cultural conditions;
  • supporting national regulatory agency assessment in the Russian Federation; and
  • providing technical assistance to national medicine regulatory authorities on the implementation of the WHO certification scheme on the quality of pharmaceutical products in Tajikistan and Turkmenistan.

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2015 - Cyprus

Assistance in analysing the pharmaceutical sector in Cyprus

Following a request from the Government of Cyprus, WHO/Europe assisted in analysing the country’s pharmaceutical sector in the context of the 2013 memorandum of understanding with creditors from the European Commission, European Central Bank and International Monetary Fund. The memorandum called for, among other changes, the introduction of a national health system finance reform by mid-2016 to allow free choice of provider, social equality and solidarity, financial sustainability and universal coverage of a minimum benefit basket.

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2015 - Hungary

Support for improving budget control for outpatient medical devices in Hungary

The Hungarian Ministry of Health requested WHO/Europe’s assistance with its pricing and reimbursement system for outpatient medical devices. Expenses related to outpatient medical devices increased significantly compared to predictions during the past 5 years in Hungary; though the overall amount spent remained fairly stable during 2011, 2012 and 2013, it is estimated to have increased by about 9% in 2014. The Government of Hungary is looking for solutions to improve budget control in this area.

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