Abstract: The introduction of new regulatory framework regarding pharmaceutical pricing and reimbursement  policies,  health technology assessment leads to fair pricing and equitable access to health technologies, including innovative medicines, whilst improving the sustainability of pharmaceutical  system in Ukraine. It was observed the growth of pharmaceutical market in Ukraine by 12.4% in US dollar terms in 2017 and increased medicines consumption in the reimbursement list by 85%. Introduction of external reference pricing in the new reimbursement programs have shown benefit to all stakeholders in order to provide access to medicines and cover unmet need. Ensuring affordable medicines requires functioning regulatory and procurement  systems, legal provisions governance and efficient management.  The results of review highlights that HTA use in the development of National List of Essential Medicines leads to efficient allocation of the budget in line with the international practice and multiple criteria decision analysis is perspective tool in the decision-making in Ukraine.