Аналіз макроекономічних показників стану розвитку систем охорони здоров’я у референтних для вітчизняного фармацевтичного ринку країнах

Regulation of drug availability is one of the most important areas of state policy in the pharmaceutical market. The use of various methods of price regulation allows achieving the desired socio-economic results, but the complexity of the processes taking place in the pharmaceutical market and in the state necessitates the constant revision of existing approaches and measures. The aim: to conduct an analysis of macroeconomic indicators characterizing the state of development of healthcare systems in countries that are reference for the domestic pharmaceutical market. Materials and methods. General theoretical (historical, formal, graphical, hypothetical-deductive, etc.) and applied (organizational-economic, mathematical-statistical, etc.) research methods were used. The subject of the research was the World Bank health indicators, which are integrated with WHO data, and data from the Organization for Economic Cooperation and Development for reference countries (Poland, Slovakia, the Czech Republic, Latvia, Hungary, Romania, Moldova, Bulgaria) and in Ukraine. Results. It was found that for the vast majority of indicators characterizing the state of health care financing, domestic indicators significantly differed from the average values for the group of reference countries. For indicators of domestic health care expenditures (four indicators), domestic data had critically low values (52.12% –% in current healthcare spending, expenditures per capita, including at purchasing power parity of the population – $ 192.81 and $ 570.60, respectively). Only for the indicator of domestic public health care expenditures as a% of general government expenditures, Ukrainian indicators (10.56%) were within the fluctuation range of the corresponding data for the group of reference countries. A comparative analysis of current healthcare expenditures (3 indicators) showed that out of the three indicators, the values of two in Ukraine were close to the minimum values in the group of reference countries. These are current healthcare expenditures per capita, including at purchasing power parity. In Ukraine, the values of these indicators were $369.90 and $1095.06, which were 3.72 and 2.49 times lower than the average values for the group of reference countries. According to the indicators characterizing the participation of private capital and citizens in healthcare expenditures (5 indicators), it was established that per capita private expenditures in Ukraine were $177.10, which was 1.88 times lower than the average for the group of reference countries ($332.58). In terms of private and out-of-pocket expenditures as a% of current healthcare expenditures, domestic data had the highest values compared to reference countries. Thus, private and out-of-pocket expenditures in Ukraine were 1.76 and 1.88 times higher than the average values for reference countries (27.07% and 24.04%, respectively). Domestic out-of-pocket expenditures calculated per capita ($167.54) and at purchasing power parity ($ 495.88) were 44,49% and 17,51% lower than the corresponding average values for the group of reference countries ($301.82 and $ 601.10, respectively). It was found that within the group of reference countries, the drug consumption index varied. This index ranged from $523.0 (Poland) to $883.0 (Bulgaria). The average consumption value in Ukraine for 2021-2023 was ($112.33), which was 5.79 times less than the corresponding data for the group of reference countries. In addition, in the group of reference countries, there are fundamental differences in the structure of population spending on medicines by funding sources (state, private revenues, and health insurance funds). Conclusions. Significant differences in macroeconomic indicators characterizing the state of healthcare financing in the reference countries and in Ukraine have been identified. This necessitates further research on the topic and a review of the group of reference countries used in the domestic pharmaceutical market to regulate the socio-economic accessibility of medicines for the population