Analysis of patients accessibility to asthma medications recommended by guidelines for pharmacotherapy of bronchial asthma under martial law

Abstract

Bronchial asthma (BA) remains a global problem and according to statistics in Ukraine its prevalence is 0.5% among the adult population. The key document regulating the pharmacotherapy of BA is the Global Strategy for Asthma Management and Prevention (GINA), which is updated annually, each sub- sequent revision contains updated recommendations based on new evidence. Dynamic changes in asthma pharmacotherapy guidelines and martial law in Ukraine require research the possibility of patients with asthma receiving recommended medications to ensure high-quality, effective, and evidence-based medical care. At the same time, there are practically no scientific publications that would highlight the problems of accessibility of asthma patients to necessary medications. The aim of thе study – to investigate the patients accessibility to asthma medications (AM) recommended by modern guidelines for asthma pharmacotherapy in a separate pharmacy under martial law. The investigation used methods of analysis and generalization of information, methods of calculation and comparison of the data obtained, and statistical analysis methods. The results of the study showed that in a separate pharmacy, patients have access to all recommended pharmacological сlasses of AM of various international non-proprietary names, dosages, both domestic and foreign manufacturers in the form of monomedicines and combinations in one inhaler. The list of AM that are subject to reimbursement under the "Affordable Medicines" program is smaller than the assortment in the pharmacy, at the same time, this list provides patients with access to AM that allow them to implement key areas of asthma pharmacotherapy, in particular basic MART-therapy. Analysis of AM sales through the "Affordable Medicines" program significantly exceeded sales through a pharmacy on general terms, some AM were sold exclusively through the reimbursement program. The investigation results proved that asthma patients have adequate access through pharmacies under martial law to the AM recommended by the asthma pharmacotherapy guidelines. However, the range of AM available in the "Affordable Medicines" program needs to be expanded by adding long-acting beta-2-agonist monodrugs and expanding the range of international non-proprietary names among all pharmacological classes to increase the availability of AM for asthma patients and improve the effectiveness of asthma pharmacotherapy.