Medicine for an elderly person: how to cut costs legally

As of 1 January 2026 the average pension in Ukraine was ≈ $146, and 54.9% of pensioners received up to ≈ $111 a month. From this sum people first pay for gas, electricity and water, then buy bread and cereal. What is left at the end is often less than a month's set of medicines.

Chronic illnesses do not come “for a week”. Blood pressure, heart, diabetes, chronic lung diseases: the medicines are taken every day and for years. The bill for a skipped pack does not arrive the same day, and that is exactly why the “medicine” line is crossed out more easily than the “bread” line.

There is a second, quieter reason. A person buys a drug by the name on a box someone once recommended, and for years pays for exactly that name. Meanwhile the same active substance can be in the pharmacy under several trade names at noticeably different prices, and it is worth asking aloud about that difference.

The programme is called “Affordable Medicines”. It is administered by the National Health Service of Ukraine within the programme of medical guarantees, and it is the state that reimburses the pharmacy for the cost of the drug or part of it.

The list of areas is broad: cardiovascular and cerebrovascular diseases, diabetes mellitus and diabetes insipidus, chronic diseases of the lower respiratory tract, mental and behavioural disorders, epilepsy, Parkinson's disease, pain relief for palliative patients, glaucoma, migraine. The list of drugs is reviewed and updated by NHSU orders, so you need to look at the current version on the service's website, not an old printout or someone's advice from three years ago.

Some items are dispensed free, some with a co-payment. Manufacturers' participation in the programme is voluntary: they submit applications themselves for a drug to get onto the list. So the content of the list changes over time, and what was not there last year may be there this year.

The prescription is electronic. It is issued by a doctor in the electronic healthcare system, and the simplest route is the family doctor with whom a declaration is signed. Formally a declaration is not required: a specialist doctor or a doctor at a private clinic can also issue a prescription if they are registered in the system and work with an electronic signature.

After the prescription is issued, an SMS arrives on the person's phone with the prescription number and its redemption code. At the pharmacy they give these two numbers, the pharmacist finds the prescription in the system, dispenses the drug and redeems the prescription. A separate paper with a stamp is not needed for this.

If the SMS does not arrive, it is not a dead end. The most common causes are an outdated phone number in the system or an offline authentication method chosen at registration. In that case the doctor prints an information note to the prescription with the number and redemption code, and it is this that becomes the basis for dispensing at the pharmacy. The phone number in the system should be updated as soon as it changes.

A prescription under the “Affordable Medicines” programme is valid for 30 calendar days from the date of creation, that is, from the day the doctor signed it with an electronic signature. For ordinary prescription medicine that a person buys at their own expense the period is longer, 90 calendar days. These two periods are confused most often, and because of this a prescription for subsidised medicine manages to expire.

An original drug is the one a company launched on the market first and on which the effect was first proven. A generic has the same qualitative and quantitative composition of active substances and the same dosage form as the reference drug, and its bioequivalence has been proven by appropriate studies. This is supervised by the State Expert Centre of the Ministry of Health of Ukraine.

That is exactly why an electronic prescription is written by the international non-proprietary name, that is, by active substance, not by brand. A trade name is stated only in exceptions: when the drug has no international non-proprietary name, when it is of biological origin or when it is a biosimilar.

The practical consequence is simple. For one prescription a pharmacy may have several packs with the same substance at different prices. Within the programme the state compensates the cost of the cheapest drug that has applied to take part, and for original innovative drugs it reimburses a fixed sum per pack, and the patient pays the rest.

What a person can do about it: ask the doctor and the pharmacist whether there is, for this prescription, an option that the programme covers fully. You can and should ask, but you must not change the drug yourself: a substitution is the doctor's decision.

The prescription is personal. It is issued for a specific person in the electronic system, and the redemption code arrives on their phone. Without this pair of numbers the medicine under the programme will simply not be dispensed, so “I'll take it on your prescription” does not work even technically.

The other side is more important. The dose and the substance itself are chosen for a specific person's diagnosis and for everything else they already take. The same name on the box does not mean this dose suits a neighbour with the same blood pressure. That is a decision for a doctor, not a family council in the kitchen.

And a third, everyday point. When an elderly person gives their pack to someone else, they are left without medicine until the next prescription, and going for a new one is far and hard. It is cheaper to take the neighbour to her doctor and get a prescription issued for her.

Come to the doctor with a list of everything the person takes, and with the boxes themselves. It happens that two boxes with different names contain the same active substance, and it should be the doctor who sees this, not the patient in the kitchen.

Ask about the programme directly, in the same words: “is my medicine in Affordable Medicines”. The question is short, and it will either give an answer or close the subject, while silence gives nothing.

Since 1 July 2025 a contract with the National Health Service of Ukraine under the programme has become a mandatory condition for pharmacies, so the choice is not narrowed to one “own” pharmacy. A contract still does not guarantee a particular pack on the shelf, so before leaving home it is useful to check the NHSU map of pharmacies or call the free 16-77 and ask for the address of the nearest one. For a person of eighty this saves not money but strength, of which there is little anyway.

Do not buy for the future. A pack bought “just in case” often waits in a drawer until its expiry date, and the money for it has been spent today.

It happens that the programme is fine, but there is still a co-payment, and there is no money for it. What helps here is not advice but people nearby: children, neighbours, a social worker, the parish, acquaintances.

Charitable organisations work the same way. The Real Help charitable organisation, for example, buys groceries and medicine every month for lonely elderly people and delivers them by hand through helpers, that is, it covers not “need in general” but a specific month of a specific person.

If an elderly person lives near you, the most useful thing is often not money. Going with them to the doctor, writing the prescription number in big digits on a piece of paper, calling 16-77 for them: this is what they can no longer do themselves, and it is exactly this that settles the matter.