Assessment of the availability and affordability of blood glucose self-monitoring devices under martial law

In humanitarian crises, disruptions to the continuity of treatment for people with diabetes may have longterm consequences, given the need for continuous glycaemic monitoring and regular adjustment of therapy. Blood glucose monitoring using glucose meters is recognised as a cost-effective strategy for improving glycaemic control and preventing complications. The aim of this study was to conduct a comprehensive analysis of the structure of the Ukrainian market for blood glucose test strips and to investigate their availability and affordability under martial law. The study also sought to assess the effectiveness of the reimbursement programme and provide evidence-based recommendations for its improvement. The object of the study was the retail segment of the Ukrainian test-strip market and government mechanisms for ensuring their availability to the population. The study materials consisted of data on commercially available test-strip products. Marketing analysis methods were applied. Physical availability was assessed based on the level of test-strip distribution within the pharmacy network, while affordability was evaluated by calculating the financial burden associated with maintaining a specified frequency of glycaemic monitoring over a defined period in relation to the corresponding income levels of the population. An analysis of the retail pharmaceutical market in Kyiv identified a broad assortment of 64 test-strip products, although only 89 % of these products were actually available. The Ukrainian market is dominated by test strips in the mid-price segment (UAH 310–420), a significant proportion of which, together with products in the low-price segment (UAH 160–290), are included in the reimbursement programme. Test strips in the highprice segment (UAH 510–800) coast 2.5–3 times more than products in the low-cost segment. This reflects the price differentiation within the market and provides patients with an opportunity to select products according to their financial means. The highest financial burden was identified among pensioners and individuals earning the minimum wage. For these groups, the cost of meeting the monthly need for test strips in certain price segments exceeded 10 % of their monthly income, which was considered critical. The findings support the continued development of government reimbursement mechanisms for blood glucose self-monitoring supplies as a means of improving their affordability and ensuring continuity of selfmonitoring for patients with both type 1 and type 2 diabetes, particularly among socially vulnerable population groups.