ANALYSIS OF THE SUPPLY OF PRODUCTS FOR SPECIAL MEDICAL PURPOSES TO CHILDREN WITH PHENYLKETONURIA

Abstract

Phenylketonuria (PKU) refers to hereditary disorders of amino acid metabolism, which requires long-term, high-cost treatment (use of special medical nutrition – SMN). The article is devoted to the analysis of the state of providing children with PKU with the necessary products of SMN in accordance with the requirements of current legislation in terms of price and physical availability. Significant differences in approaches to providing patients with PKU with SMN products, their classification and assortment, specifics of prescribing by physicians and reimbursement in different countries were identified. It was found that doctors most often prescribe powdered amino acid mixtures (AAM) (73%) of foreign production (Great Britain, Italy, Germany, Spain) at a price from UAH 1,000 to 7,000 per package (500 g jar). The main criteria for the selection of SMH by doctors are the optimal protein content in a product unit for a certain age group, a balanced amount of nutrients and the lowest cost of 1.0 g of protein. The analysis showed that the amount of protein in 100 g of the product varies from 2.0 to 83.3, the cost of 1 g of protein is from 13.50 to 109.00 UAH. In Ukraine, according to the legislation, such products should be classified as SMN and, accordingly, could be taxed at a preferential VAT rate of 7% instead of 20%. This would make it possible to significantly increase the availability of SMN for patients and reduce the burden on the budget, which is confirmed by the relevant forecast calculations. Thus, a consistent comprehensive state policy in the field of providing patients with orphan metabolic diseases, in particular PKU/HPA, aimed at providing them with safe and affordable SMN products (in particular due to the development of domestic production and the introduction of preferential taxation), will increase the duration and quality of life of such patients.