Publication: Final Report with Recommendations for Reforming Bulgaria’s Pharmaceutical Sector
Date
2015-05
ISSN
Published
2015-05
Author(s)
World Bank
Abstract
This report presents a review of current
issues in the pharmaceutical sector in Bulgaria, examining
drug policy, regulation, pricing, formulary selection,
distribution, expenditure, and to the extent possible,
patterns of use in Bulgaria. Its recommendations are
intended to serve as options for reform, by articulating
short and long term strategies for managing pharmaceutical
expenditure, improving system sustainability, and driving
value for money in Bulgaria, thereby improving efficiency,
equity, affordability and ultimately, access to prescription
medicines. Although small, the Bulgarian pharmaceutical
market is showing strong growth. Medicines comprise not only
a disproportionate share of health care expenditure (38
percent of total health expenditure, compared with an EU
average of around 25 percent), the burden of out of pocket
(OOP) costs is also excessive, possibly as high as 81
percent of total pharmaceutical expenditure. Of perhaps
greatest concern is that rapid expenditure growth is taking
place without obvious improvements in health outcomes, and
at the expense of population equity. Bulgaria does not yet
have an integrated national medicines policy, and the
pharmaceutical sector is characterized by various highly
prescriptive and at times, arguably inconsistent policy
levers. While the regulatory framework has been largely
brought into line with current EU standards, existing
mechanisms for listing, pricing and subsidizing medicines
are not ensuring adequate value for money for the National
Health Insurance Fund (NHIF), and are contributing to
inefficiencies in the health sector. Current pharmaceutical
policy settings appear focused on limiting NHIF outlays
rather than prioritizing access and affordability, and
afford little financial protection to patients.
Citation
“World Bank. 2015. Final Report with Recommendations for Reforming Bulgaria’s Pharmaceutical Sector. © Washington, DC. http://hdl.handle.net/10986/23248 License: CC BY 3.0 IGO.”