Analysis of the effectiveness of botulinum toxin type A procurement and access to tiered injections for children with spastic cerebral palsy in Ukraine

The relevance of the study is determined by global changes in medicine, where an important request is to find effective methods of treatment of pediatric diseases, in particular cerebral palsy (CP), which is the main cause of pediatric disability. According to the World Health Organization, CP is common in 2-5 cases per 1,000 children, and 75% of them have a spastic form, which requires a special approach to treatment. Injections of botulinum toxin type A are one of the most effective methods of reducing spasticity. However, there are problems with access to these drugs in Ukraine, which emphasizes the need to analyze their supply and use in regions. The aim of the study was to analyze the provision, availability, and use of medicines for the treatment of a spastic form of CP in Kyiv, Zhytomyr, Kharkiv, Dnipro, Zaporizhzhia regions and the city of Kyiv. Materials and methods. The study covered the monitoring of botulinum toxin type A supply for the period 2019-2023. It consisted of two parts: data were obtained from open databases and official websites, including the Ministry of Health of Ukraine and medical institutions. To assess the drugs prescribed to patients and the level of satisfaction with the supply, surveys and interviews were conducted with patients and healthcare professionals. The survey covered 530 patients with a response rate of over 90%. Results. The study showed that 40% of respondents complained about the lack of free medicines, and 20% noted their absence in medical facilities. A decrease in delays in supply and problems with treatment interruption were noted by 5% of respondents. Successful public procurement related to the increase in the volume of medicines procured has reduced costs during tenders. Conclusions. The main factors limiting the provision of medicines for the treatment of children with CP are insufficient funding and an inefficient procurement system in Ukraine. The authors declare no conflict of interest.