The population’s limited access to medication remains one of the major challenges of the healthcare sector. In accordance with UNICEF’s Welfare Monitoring Survey, 27.8% of Georgia’s population reports that the purchase of medicine is the main problem. UNICEF’s survey demonstrates that since launching the universal healthcare programme, people’s financial affordability vis-à-vis healthcare services has improved. However, the population’s total healthcare expenses have increased significantly which was largely stipulated by increased costs of medicine. The largest share of the population’s healthcare expenses; that is 69%, goes for medication. Increased prices on medication directly impact the pockets of the population because the universal healthcare programme does not envision funding medication.

The State Programme for Providing Medicine for Chronic Diseases was launched on 1 July 2017 with a view to providing better access to medicine. However, two years after the programme’s commencement and in spite of its expansion, people’s low involvement within is a significant challenge. The Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs of Georgia has been failing to fully use the programme’s budget for three years in a row.

What Are the Changes in the State Programme for Providing Medicine for Chronic Diseases?

In July 2019, amendments were enacted in the State Programme for Providing Medicine for Chronic Diseases which concerned the medication funding rule. In accordance with the amendments, together with socially vulnerable people, pensioners and disabled people will also be allowed to purchase programme-covered medications for a symbolic price (GEL 1). In addition, 75% of Parkinson and epilepsy medication costs will be covered for each Georgian national.

Until now, only socially vulnerable people were allowed to purchase medications for a symbolic price (GEL 1) as a part of the programme. Old age pensioners, disabled people and those suffering from Parkinson and epilepsy had access to 50% funding for their respective medication costs.

At the initial stage, the State Programme used to cover to socially vulnerable citizens with chronic diseases. Prescription medications for chronic cardiovascular, lung and thyroid diseases as well as for type 2 diabetes (non-insulin dependent), comprising a total of 23 different medications, have been funded as a part of the programme. Since September 2018, the programme has expanded and started to cover old age pensioners and persons with disabilities. Medication to treat Parkinson and epilepsy were added to the programme in December 2018. Currently, 35 different medications for treating six chronic diseases are funded as a part of the programme.

Population’s Involvement

In the course of two years, the State Programme for Providing Medicine for Chronic Diseases has expanded a number of times and, therefore, the number of programme beneficiaries has also increased. However, the involvement figure still remains low. In accordance with the estimates of the Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs, the so-called free medicine programme should have covered nearly 150,000 – 200,000 people. In 2017-2019, a total of 56,400 people were registered as beneficiaries of the State Programme for Providing Medicine for Chronic Diseases. In 2017, the number of programme beneficiaries was 13,010. In 2018, 22,651 new beneficiaries were registered in the programme. In the first six months of 2019, an additional 20,748 people have also become programme beneficiaries.

Budget

If we take a look at the budget execution figures, the Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs fails to execute the budget which in turn is stipulated by the low involvement of people. In 2017, the budget for the State Programme for Providing Medicine for Chronic Diseases was set at GEL 3.3 million although real spending amounted to GEL 2.6 million. In 2018, the budget for the State Programme for Providing Medicine for Chronic Diseases was set at GEL 10 million whilst the actual execution of the programme’s budget was GEL 7.6 million. Of importance is that in accordance with the State Treasury data, for the first 11 months of 2018 only GEL 590,000 was spent from the budget. The bulk of the 2018 budget was spent at the end of the year, in December. At the end of 2018, when it became evident that the Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs had failed to execute the programme budget, it was decided to purchase and store medication as a part of the free medication programme. The programme’s expansion in December 2018 is also related to a low involvement within.

In 2019’s budget, funding for the State Programme for Providing Medication for Chronic Diseases is doubled and set at GEL 20 million. In accordance with the State Treasury data, in the first six months of 2019, the programme’s real expenses were nearly GEL 1.2 million which constitutes 6% of the annual budget.

The amendment enacted in July 2019, which envisions allowing disabled people and pensioners to purchase medicine for a GEL 1 symbolic price instead of the previous 50% funding, is most likely related to the poor performance of the programme’s budget execution.