On August 1, an important innovation in the medical system began to operate in Ukraine, aimed at solving the acute global problem of increasing resistance to antibiotics due to their uncontrolled and irrational use. The Ministry of Health of Ukraine warned about the changes in advance , and on the eve of the department, in the “question-answer” format, told in more detail that these changes would be in practice for the end patient.
It is worth noting that the rule itself on the release of antibacterial drugs by prescription is not new, and from August 1, a new digital tool begins to work – an electronic prescription. This is one of the steps in countering the global problem of antibiotic resistance. 
Antibiotic resistance is the ability of microorganisms to survive and multiply under the influence of antimicrobial agents. Infectious diseases that lead to resistant bacteria are difficult and sometimes impossible to cure – in such a situation, recovery often depends only on the internal capabilities of the immune system. . This will allow tracking data on the prescription and volume of antibiotic use in Ukraine. In Ukraine, the problem of misuse of antibiotics has always been quite acute, and it has become especially rampant during the coronavirus pandemic – in 2020, the Ministry of Health reported that the consumption of antibiotics increased by 3.5 times compared to the same period in 2019. Below is a detailed explanation of the Ministry of Health on the operation of the mechanism for dispensing antibiotics by electronic prescription in the “question-answer” format
What do patients need to know about launching an e-prescription for antibiotics?
- Why can’t you buy antibiotics on your own without a doctor’s prescription?
An antibiotic is a serious prescription drug that should only be prescribed by a doctor. Only a doctor can determine the appropriateness of taking an antibiotic, choose an effective active ingredient, dosage and regimen of taking the drug. Self-prescription and uncontrolled use of antibiotics can not only damage human health, but also stimulate the development of a global problem – antibiotic resistance, as a result of which bacteria become resistant to treatment. This can lead to the fact that infectious diseases, which today are quickly and without consequences treated with antibacterial drugs, can turn out to be deadly.
- Which doctors will write e-prescriptions for antibiotics?
An electronic prescription can be obtained directly at the doctor’s appointment. The technical possibility of issuing prescriptions will be available to both public and private doctors. More – a prescription can be written by a doctor of any level of medical care and specialization – a general practitioner, surgeon, dentist, etc. The main condition is that the institution and doctors must be registered in the electronic health system. If the institution you applied to does not yet work with the EPHS, the doctor will write a paper prescription.
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During the transitional period, the patient will be able to purchase the necessary prescription medication at any pharmacy. To do this, it is enough to present to the pharmacist an information certificate, which the doctor will issue as confirmation of the e-prescription, or a paper prescription. Please note that prescription antibiotics can be purchased within 30 days of being issued.
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Can I partially redeem an e-prescription, i.e. purchase a smaller amount of the drug than specified in the prescription?
The doctor in the prescription indicates the active substance of the drug, dosage and duration of treatment. At the same time, the patient can independently decide on the brand of the drug and partially pay off the prescription in accordance with his budget. The functionality of an electronic prescription allows you to make a partial release of the medicine and divide the purchase into several times. There is no need to get a second prescription from a doctor.
When dispensing, the pharmacist will stamp “Dispensed” on the information certificate and indicate the amount of the dispensed medicinal product. If repaid again, the patient will be able to use the same prescription.
- Do I need a declaration to receive an e-prescription? What are the other conditions?
To obtain an electronic prescription for antibiotics, a declaration is not required. However, the patient must be registered in the e-health system. This can be done in two ways: by making a declaration with a family doctor or by registering directly for an appointment with any doctor. To do this, it is enough for the patient to have an identity document (internal or international passport, ID-card, for children – a birth certificate) and a taxpayer registration number (TIN) (mandatory for everyone who has reached the age of 14, an exception – the patient refused the acquisition of such a number, which is confirmed by the corresponding mark in the patient’s passport);
This means that Ukrainians who are temporarily forced to change their place of residence will be able to get a prescription from a doctor without a declaration.
- How to get and pay off a prescription for an antibiotic in villages where there is limited access to medical services?
It is assumed that during the transitional period in remote regions and in rural areas, in the absence of doctors and limited access to medical services, paramedics can issue prescriptions for antibiotics.
Also, in the absence of a pharmacy in rural areas, retail trade in medicines is carried out in the premises of feldsher, feldsher-obstetric stations in rural areas, district hospitals, outpatient clinics, general practice outpatient clinics by employees of these institutions with medical education.
- How to get the right antibiotic in the territories where the hostilities are taking place / under occupation?
For those pharmacies located in the area of hostilities or in territories under temporary occupation, surrounded, an exception will apply. Such pharmacies will temporarily continue to dispense prescription antibacterial drugs to patients without a doctor’s prescription during the state of war.
The list of such settlements was approved by the relevant order of the Ministry for the Reintegration of the Temporarily Occupied Territories.
- How will volunteers be able to purchase antibiotics?
As well as voluntary and charitable organizations, at the request of the relevant institution, military unit or health care institution may purchase prescription drugs directly from distributors without a prescription. In other cases, when it comes to buying antibiotics for individual use through a pharmacy, the dispensing is made by prescription.
- How will e-prescriptions be issued in a hospital?
It is important to note that if a medical institution provides inpatient treatment services under the terms of cooperation with the NHSU, then the medicines, in particular antibiotics, provided for in the treatment package, must be guaranteed to be provided to the patient free of charge. The patient does not need to write a prescription to prescribe and use medicines.
If we are talking about exceptional situations, when for some reason the patient needs drugs that are not covered by the treatment package, then the hospital doctor will be able to write a prescription for the patient.
- Will pharmacists have access to a patient’s medical information when paying off a prescription?
No, the pharmacist will only see information about the prescription given by the doctor when issuing an antibiotic prescription.
Full access to the patient’s medical record, with his consent, has only the doctor with whom the patient has concluded a declaration and it is active. The specialist doctor can only view relevant episodes, i.e. related to a referral from a family doctor. Access to other medical records of the patient by doctors of secondary medicine is provided only with the consent of the patient.
- How to buy an antibiotic for pets?
Medications for animals can still be purchased with a veterinary prescription.
