Experience of Great Britain in organization of healthcare system for pharmaceutical provision with medicines for privileged categories of citizens

Background. Health is the highest value not only in the context of the perception of a person, but also society and the state as a whole. According to the content of international documents approved by the UN General Assembly, the WHO, the World Medical Association, governments should be responsible for the health of the population, ensure the implementation of the human right to life and health. Previously, the state of affairs in Ukraine regarding the pharmaceutical provision of privileged categories of citizens was studied. However, for forming a powerful and effective health care system in Ukraine for the pharmaceutical provision of privileged categories of citizens, it is useful to analyze the experience of providing health care in economically developed countries. The purpose of the research was to study the Great Britain experience with the organization of a healthcare system for the pharmaceutical provision of medicines to privileged population groups. Materials and methods. Common methods of normative legal, documentary, retrospective and comparative analysis used to gain that purpose. Results. The system of financing health care in the Great Britain provides getting finances mainly from the state budget, while the division takes place on the management vertical from the highest level to the lower one. The taxes that make up about 90% of the health care system budget are the financial basis of the national health system of the Great Britain. For comparison, only 7.5% comes from employers. Therefore, can argue that the healthcare system of the Great Britain in fact completely financed by financial contributions from taxpayers and by the government. There are three main models of financing health care allocated in the world practice: private, budget (model Beveridge), mixed (Bismarck model). A private financing model exists through the creation of sustainable competition between healthcare facilities. The part of private insurance is about 40% of total costs, and the patient himself covers the cost of pharmaceutical provision. A private financing model is typical for such developed countries as the United States of America and Japan. The budget model of funding or the Beveridge model means covering a large part of the costs of pharmaceutical provision by state institutions. This model is also typical for Great Britain. A mixed financing model or Bismarck model based on the three foundations: the state, enterprises and personal funds of a citizen. This system of insurance financing is typical for Germany, Austria and France. Private medicine in the Great Britain is one of the most advanced and most expensive in the world. There are about 300 non-state hospitals in the country, that receive a license at a local the National Health Service unit and tested twice a year. There are no queues here and medical care provided in full and to the extent necessary. The services of pay-doctors and cabinets paid either by insurance companies or by patients themselves. Large companies in Britain have health insurance as an additional paycheck bonus. Conclusions. According to the Great Britain experience, compulsory medical insurance takes place in countries with predominantly state funding. The Beveridge model is widespread in many countries where the state provides coverage of 80% or more of health care costs (Canada, Australia, Greece, Sweden, and Spain). Despite significant changes in the health care system of the Great Britain, the opportunity to choose the type of insurance and to take advantage of the benefits for the purchase of medicines and medical products, that allowed to increase competition between health facilities and, accordingly, to improve the quality and speed of pharmaceutical provision of patients. Thus, budget medicine of Great Britain is a priority for many world countries and a guarantee of state financing of pharmaceutical provision for privileged categories of citizens, regardless of income level and social status.


Introduction
Health is the highest value not only in the context of the perception of a person, but also society and the state as a whole. According to the content of international documents approved by the UN General Assembly, the WHO, the World Medical Association, governments should be responsible for the health of the population, ensure the implementation of the human right to life and health [6].
Previously, the state of affairs in Ukraine regarding the pharmaceutical provision of privileged categories of citizens was studied [9].
However, for forming a powerful and effective health care system in Ukraine for the pharmaceutical provision of privileged categories of citizens, it is useful to analyze the experience of providing health care in economically developed countries.
The purpose of the research was to study the Great Britain experience with the organization of a healthcare system for the pharmaceutical provision of medicines to privileged population groups.

Materials and methods
Common methods of normative legal, documentary, retrospective and comparative analysis used to gain that purpose.

Results and discussion
The system of financing health care in the Great Britain provides getting finances mainly from the state budget, while the division takes place on the management vertical from the highest level to the lower one.
The taxes that make up about 90% of the health care system budget are the financial basis of the national health system of the Great Britain. For comparison, only 7.5% comes from employers. Therefore, can argue that the healthcare system of the Great Britain in fact completely financed by financial contributions from taxpayers and by the government [2].
There are three main models of financing health care allocated in the world practice: private, budget (model Beveridge), mixed (Bismarck model) [10]. A private financing model exists through the creation of sustainable competition between healthcare facilities. The part of private insurance is about 40% of total costs, and the patient himself covers the cost of pharmaceutical provision. A private financing model is typical for such developed countries as the United States of America and Japan.
The budget model of funding or the Beveridge model means covering a large part of the costs of pharmaceutical provision by state institutions. This model is also typical for Great Britain. A mixed financing model or Bismarck model based on the three foundations: the state, enterprises and personal funds of a citizen. This system of insurance financing is typical for Germany, Austria and France.
Private health insurance covers healthcare services that not provided by the National Health Service. Private insurance companies are essentially complementary to the public health care system of the Great Britain; therefore, only risk insurance foreseen beyond the competence of the health service. The GB's private health insurance only includes a paid medical care at commercial and public health facilities. Great Britain budget financing has a number of disadvantages: the monopoly of the insurance market; the lack of the actual ability to elect a doctor or health care provider [3].
Currently, the Great Britain government is working to increase the effectiveness of providing medical care and pharmaceutical provision to different categories of citizens by increasing competition between types of funding [4].
The Great Britain has a centralized state healthcare and social welfare system -the National Health Service (NHS). A minister in charge of 14 regional health departments that, in their turn, subject to 145 local health departments and 90 family health departments [9] heads the healthcare system.
The main principle of the healthcare of Great Britain is free medical care for all contingents of the population living legally on the territory of the country. The main source of funds for health care is the state budget. The basis of the functioning of the dynamic health sys- Private insurance used by about 12% of the population of Great Britain, who receives services from private, companies as a supplement to funding from the NHS. In this case, the patient will not be able to rely on free medicines from the NHS. In part or in full, the patient should paid for the dentistry help, dental prosthesis, etc. by his own account in part or in full [1].
OTC medicines are paid for their own funds, while prescription medicines were first issued free of charge, but this led to the unjustified consumption of free medicines and became an overwhelming burden for the state, which led to the revision and the introduction of a fixed co-payment for each prescribed recipe. The prescription period in the GB is up to 6 months, while the medicines with narcotic and psychotropic components is 28 days [8].
The conditions for the provision of medicines differ in different parts of the Great Britain: the inhabitants of England pay a recipe of 7.65 (from April 2012), in Wales, Scotland, Northern Ireland -the co-payments are canceled.
About 90% of medicines and medical products are released free of charge for certain categories of the population (table).
Need to note, that there are monthly and annual certificates for patients who are continuously taking the drug, which reduces the cost of the prescription.
There is a so-called "black list" in Great Britain, that includes medicines prohibited for free provision, but permitted for own purchasing. There is also a "gray list" of medicines, which includes medicines for prescribing only in special cases or special patients [10].
Private medicine in the Great Britain is one of the most advanced and most expensive in the world. There are about 300 non-state hospitals in the country, that receive a license at a local NHS unit and tested twice a year. There are no queues here and medical care provided in full and to the extent necessary. The services of pay-doctors and cabinets paid either by insurance companies or by patients themselves. Large companies in Britain have health insurance as an additional paycheck bonus [5].

Conclusions
According to the Great Britain experience, compulsory medical insurance takes place in countries with predominantly state funding. The Beveridge model is widespread in many countries where the state provides coverage of 80% or more of health care costs (Canada, Australia, Greece, Sweden, and Spain). Despite significant changes in the health care system of the Great Britain, the opportunity to choose the type of insurance and to take advantage of the benefits for the purchase of medicines and medical products, that allowed to increase competition between health facilities and, ac-cordingly, to improve the quality and speed of pharmaceutical provision of patients. Thus, budget medicine of Great Britain is a priority for many world countries and a guarantee of state financing of pharmaceutical provision for privileged categories of citizens, regardless of income level and social status.