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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