Ukrainian medicine is entering another round of changes – the same ones that in Europe and the USA have long ceased to be reforms and have become simply commonplace. On paper everything looks logical and even reassuring. But there is a nuance: in a country where there is a war, any minor mistake in the system can turn into a big failure in real life.

Therefore, you need to approach these updates with a cool head: not from the position of “everything is perfect”, but from the position of “the idea is correct, but let’s see how it will work on the ground”. Because even the best reform can fail if you do not take into account real conditions - the shortage of resources, the burden on doctors and the needs of patients, which are now changing faster than orders are updated.

Pulmonologists will be able to prescribe therapy for COPD, cardiologists will be able to prescribe drugs for the treatment and prevention of CVD. This is logical: a specialized specialist has a better understanding of complex cases than a family doctor.

European practice confirms: in Germany, France, Denmark, it is the specialist who determines the therapy, and the primary care team only coordinates the patient’s route.

But here there is a question: is our IT data and control system ready for the fact that the number of entry points for assignment will increase If control is formal, there is a risk of irrational use of funds.

On the other hand, this is a step towards real clinical logic, which we have been missing for a long time. The main thing is that specialists have the same approaches, and not “as God put it on their souls”.

Any doctor who has made a diagnosis can prescribe the drug under the program. This makes life as easy as possible for the patient: fewer queues, less running around.

Poland, Estonia, Spain did this - and they were right. However, a logical question arises: will all doctors have equal access to clinical guidelines so that prescriptions are not just quick, but correct

Reducing bureaucracy is great. But quality control of diagnoses during war becomes critically important.. Without it, any simplification may create additional costs for the state.

The inclusion of antibacterial drugs in an electronic prescription is a solution absolutely in the spirit of the EU.

In Sweden, after the introduction of e-prescriptions, antibiotic consumption decreased to 20–30%. In France – by 15–20%. This is good. Very good. But let’s be honest: in Ukraine, some patients will simply go “to the pharmacy under the floor,” and some pharmacies will “cheat”. Therefore, it is important not only to limit access, but also to teach patients why antibiotics are not candy.

This requires communication at the level of the Ministry of Health, the NHS and the pharmaceutical community. Without it, any control will only work partially.

The transition to e-prescribing is the standard in the USA (Medicare, Medicaid) and Europe. It reduces:.

In a peaceful country this is enough. In a country that has been holding back Russian aggression for four years, this is not enough.

Additional filters are needed here: analytics, deviation algorithms, control over pathological patterns of prescriptions. Otherwise, we will get a beautiful reform without real savings.

For patients. The easiest way to explain it is this: medicines will become more accessible, and getting a prescription will be faster and without unnecessary runs between offices. Less formalities - more predictability. And, at least on paper, there is a chance for transparent prescriptions, when every step of the doctor can be checked in an electronic system.

For doctors. Specialists get more real authority, and family doctors get fewer bureaucratic responsibilities that have been draining the system for years. At the same time, responsibility for the correct diagnosis increases: prescriptions become more personal and more visible in the digital ecosystem.

For the state. Antibiotic control ceases to be a theory and becomes a tool of national security - this is especially true in wartime. The pharmaceutical market is becoming more transparent, and the chance for budget savings is real, but only on the condition that the control system works not formally, but for real.

For the system as a whole. The direction of movement is correct, but the corridor of opportunity is very narrow: war, lack of resources, constant turbulence. Therefore, any reform today must be not just professional and logical, but stress-resistant - able to work even where conditions are far from ideal.

All these changes really bring Ukrainian medicine closer to the European rules of the game - more transparent, predictable and patient-oriented.

The logic of the reforms is correct, the direction is the same as that chosen by developed countries. But at the same time, it should be remembered: in war conditions, the healthcare system works as if on thin ice. Each step must be balanced, supported by data, control and sober analysis - without haste and without illusions.

Because reform itself is only a tool. And it gains real value when it remains flexible, adaptive and able to work for people even in the most difficult circumstances.