ABSTRACT
This chapter critically explores systemic and individual vulnerabilities to corruption by analysing socially harmful phenomena of non-evidence-based medical practices in the Ukrainian mainstream health sector. In order to understand the role of medical practitioners in stimulating the demand for non-evidence-based drugs, we have analysed the sales of pharmaceuticals at the national level in the light of evidence-based criteria for drugs, and conducted a pilot study at the National Therapy Institute (NTI) in Kharkiv analysing evidence-based and non-evidence-based prescribed pharmaceuticals for cardiovascular patients in 2014 and 2017. The results suggest that at the national level the consumption of non-evidence-based pharmaceuticals accounts for roughly two thirds of medical drug sales by volume. In addition, our pilot study suggests that about one third of pharmaceuticals prescribed by doctors for cardiovascular diseases in Ukraine have no evidential clinical basis. This practice has serious implications, not only for the health of patients, but also for increasing expenditure in the medical sector, and for lowering popular confidence in the medical establishment.
