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Is treatment with OST drugs provided free of charge and what to do if healthcare workers solicit payment for the provision of these drugs?

In Ukraine, a special Law of Ukraine “On preventing diseases caused by human immune deficiency virus (HIV) and on legal and social protection of people living with HIV” is in action. This Law provides for state guarantees of OST administration (par. 8 of Article 4). OST provision is also regulated by institutional orders of the Ministry of Health.

What you need to consider

  1. Starting from April 1, 2021, OST medical care is covered by the state-guaranteed benefit package “Treatment of individuals with mental and behavioral disorders caused by opioid consumption with the use of opioid substitution therapy drugs”.
  2. This benefit package includes the following services which must be provided free of charge:
  • Opioid substitution therapy drugs procured at the cost of centralized drugs procurement program of the Ministry of Health;
  • Elaboration of the monitoring and treatment plan;
  • Treatment monitoring; monitoring of side effects and OST drug efficiency, including individual dosage review and considering interaction of the OST drugs with other medications, including antiretroviral, TB drugs, pain relief medication, antidepressant medication, etc.;
  • Screening for TB, HIV, viral hepatitis.

To receive OST drugs, a referral of the attending physician and diagnosis F11 “Mental and behavioral disorders caused by opioid consumption” are required.

Under this benefit package, the health facility must ensure OST drug provision for administration in the outpatient clinic or at home. If the patient is unable to visit the doctor on a daily basis, for example, because of being hospitalized to another facility, the health facility must ensure the delivery of medications. 

For the full scope of services under this benefit package, please access the NHSU website and select the specification under the relevant benefit package.

Conduct of the patient if the healthcare provider solicits payment for medical care or refuses to provide the service.

  • First of all, approach the chief physician of the healthcare facility, preferably with a written report (complaint), demanding to remedy the violation of right to free medical care under the relevant benefit package, referring to availability of public funding received by the healthcare facility for provision of such services. The complaint must be duly registered, with an incoming registration number assigned.
  • If these efforts were not successful, you need to file a written report (complaint) to the city or oblast health department complaining about absence of response by the chief physician and demanding to remedy the violation of the right to healthcare. The healthcare department must duly register the complaint and respond to it. In fact, this is usually enough to correct the situation. 
  • If the client remains unsatisfied, he/she can approach the National Health Service of Ukraine (NHSU) and submit a complaint using the online form on the NHSU website. 

Usually, NHSU does not ignore such messages and may take measures up to terminate public funding provided to the health facility. Therefore, the administrations of health facilities try to avoid such complaints and prevent conflicts.

  • If the client remains unsatisfied, he/she can file a complaint in court.