Publication:
Final Report with Recommendations for Reforming Bulgaria’s Pharmaceutical Sector

dc.contributor.author World Bank
dc.date.accessioned 2015-12-08T22:46:56Z
dc.date.available 2015-12-08T22:46:56Z
dc.date.issued 2015-05
dc.description.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. en
dc.identifier http://documents.worldbank.org/curated/en/2015/11/25465740/final-report-recommendations-reforming-bulgaria’s-pharmaceutical-sector
dc.identifier.uri http://hdl.handle.net/10986/23248
dc.language English
dc.language.iso en_US
dc.publisher Washington, DC
dc.rights CC BY 3.0 IGO
dc.rights.holder World Bank
dc.rights.uri http://creativecommons.org/licenses/by/3.0/igo/
dc.subject PHARMACY
dc.subject CLINICAL GUIDELINES
dc.subject RISKS
dc.subject RETAILING
dc.subject RETAIL PRICE
dc.subject DOSAGE FORMS
dc.subject SUBSTITUTION
dc.subject CHRONIC DISEASES
dc.subject DISPENSING FEES
dc.subject ACCOUNTING
dc.subject FEEDBACK
dc.subject FINANCING
dc.subject STOCK
dc.subject PHARMACISTS
dc.subject PACKAGING
dc.subject SALES
dc.subject PREVENTION
dc.subject LAWS
dc.subject ACTIVITIES
dc.subject SUPPLIER
dc.subject ADHERENCE TO TREATMENT
dc.subject HEALTH INSURANCE
dc.subject MONITORING
dc.subject DRUGS
dc.subject HEALTH CARE
dc.subject DRUG PRICES
dc.subject HEALTH
dc.subject DRUG FORMULARIES
dc.subject DISTRIBUTION
dc.subject PRICING
dc.subject WHOLESALE PRICE
dc.subject BREAST CANCER
dc.subject PRICE
dc.subject BENCHMARKS
dc.subject RETAIL TRADE
dc.subject PRESCRIPTIONS
dc.subject CORRUPTION
dc.subject CRIME
dc.subject HYPERTENSION
dc.subject DISCLOSURE
dc.subject PRICE COMPETITION
dc.subject INFLATION
dc.subject PHARMACEUTICAL
dc.subject RETAIL
dc.subject INTERFERON
dc.subject PHARMACEUTICAL POLICY
dc.subject RANDOMIZED CONTROLLED TRIALS
dc.subject PHARMACIES
dc.subject COMMUNICATIONS
dc.subject COST EFFECTIVENESS
dc.subject MARKET SEGMENT
dc.subject WHOLESALER
dc.subject DIABETES
dc.subject ADVERTISING
dc.subject MARKET ENTRY
dc.subject PRICING MECHANISMS
dc.subject BRANDS
dc.subject PATIENT
dc.subject PATIENTS
dc.subject PHARMACEUTICAL MANUFACTURERS
dc.subject LEUKEMIA
dc.subject REBATES
dc.subject REBATE
dc.subject PRODUCTS
dc.subject MEDICATION
dc.subject NURSES
dc.subject RATIONAL DRUG USE
dc.subject PHARMACEUTICAL INDUSTRY
dc.subject HEALTH MANAGEMENT
dc.subject OBSERVATION
dc.subject MARKETING
dc.subject WHOLESALING
dc.subject INDICATORS
dc.subject BRAND PREFERENCES
dc.subject PRODUCT
dc.subject GROSS DOMESTIC PRODUCT
dc.subject PRICING POLICIES
dc.subject GMP
dc.subject BRAND
dc.subject EFFICIENCY
dc.subject NARCOTICS
dc.subject EXPENDITURE
dc.subject PHARMAC
dc.subject SUBSTITUTE
dc.subject BENCHMARK PRICING
dc.subject PROCUREMENT
dc.subject PRICE ADJUSTMENTS
dc.subject TURNOVER
dc.subject PRICE COMPARISONS
dc.subject VALUE
dc.subject PROSTATE CANCER
dc.subject MEDICINE
dc.subject PHARMACEUTICALS
dc.subject BUDGETS
dc.subject SOCIAL POLICY
dc.subject DEMAND
dc.subject HEALTH OUTCOMES
dc.subject PHARMACEUTICAL EXPENDITURE
dc.subject REPORTS
dc.subject ISONIAZID
dc.subject DRUG EVALUATION
dc.subject INSULIN
dc.subject PRICE CHANGES
dc.subject EXPENDITURES
dc.subject DECISION MAKING
dc.subject THERAPIES
dc.subject CHEMOTHERAPY
dc.subject OPPORTUNITY COSTS
dc.subject PHARMACEUTICAL PRICING
dc.subject COLD CHAIN
dc.subject NUTRITION
dc.subject MARKET
dc.subject RETAIL PRICES
dc.subject EXTERNAL REFERENCE PRICING
dc.subject SUPPLY CHAIN
dc.subject QUALITY OF LIFE
dc.subject MARKET COMPETITION
dc.subject INTERNET
dc.subject TENDERING
dc.subject GLAUCOMA
dc.subject DISTRIBUTION OF PHARMACEUTICALS
dc.subject VACCINES
dc.subject HEALTH CARE PROFESSIONALS
dc.subject PHYSICIANS
dc.subject COMMUNICABLE DISEASES
dc.subject MARKET SHARE
dc.subject CLINICAL TRIALS
dc.subject CLINICIANS
dc.subject LIVER CANCER
dc.subject PHARMACEUTICAL SECTOR
dc.subject EVALUATION
dc.subject GENERAL PRACTITIONERS
dc.subject DRUG SELECTION
dc.subject SUPPLY
dc.subject PURCHASING
dc.subject RESPIRATORY DISEASES
dc.subject MARKET POWER
dc.subject METHADONE
dc.subject TREATMENT GUIDELINES
dc.subject WAREHOUSES
dc.subject GOOD PRESCRIBING
dc.subject STRATEGY
dc.subject WHOLESALERS
dc.subject TRANSFER PRICES
dc.subject FEES
dc.subject PHARMACEUTICAL MANAGEMENT
dc.subject REGISTRATION
dc.subject SUPPLIERS
dc.subject MEDICINES
dc.subject PRICE CONTROLS
dc.subject HOSPITALS
dc.subject HEALTH SERVICES
dc.subject IMPLEMENTATION
dc.subject PRICES
dc.subject PHARMACEUTICAL PRICING POLICIES
dc.subject GENERIC PRODUCTS
dc.subject COMPETITION
dc.title Final Report with Recommendations for Reforming Bulgaria’s Pharmaceutical Sector en
dc.type Report en
dc.type Rapport fr
dc.type Informe es
dspace.entity.type Publication
okr.date.disclosure 2015-11-16
okr.doctype Economic & Sector Work
okr.doctype Economic & Sector Work :: Other Health Study
okr.docurl http://documents.worldbank.org/curated/en/2015/11/25465740/final-report-recommendations-reforming-bulgaria’s-pharmaceutical-sector
okr.identifier.externaldocumentum 090224b0831baca6_1_0
okr.identifier.internaldocumentum 25465740
okr.identifier.report 100971
okr.imported true
okr.language.supported en
okr.pdfurl http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2015/11/16/090224b0831baca6/1_0/Rendered/PDF/Final0report0w0harmaceutical0sector.pdf en
okr.region.administrative Europe and Central Asia
okr.region.country Bulgaria
okr.sector Health and other social services :: Health
okr.theme Human development :: Health system performance
okr.topic Health, Nutrition and Population :: Health Monitoring & Evaluation
okr.topic International Economics and Trade
okr.topic Macroeconomics and Economic Growth :: Markets and Market Access
okr.topic Health, Nutrition and Population :: Pharmaceuticals & Pharmacoeconomics
okr.unit HNP ECA Region (GHN03)
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