COMPARATIVE ANALYSIS OF THE COSTS OF MEDICINAL PRODUCTS IN BULGARIA AND THE EUROPEAN UNION
Keywords:
costs, medicinal products, public funds, National Health Insurance Fund, generics, European UnionAbstract
Over the last two decades, spending on healthcare, and in particular spending on medicines, has been rising in the European Union. The main reasons for that are the technological progress, improved diagnosis of diseases, increased access to medicines, disease prevention. These reasons lead to an increase in the average life expectancy of the population. Thanks to this progress, more and more fatal diseases are becoming chronic with a high chance of living a longer and fuller life. This inevitably leads to a natural increase in the cost of treating chronic diseases.
The two largest items in the budget of the National Health Insurance Fund - the main payer with public funds in the health care system in Bulgaria are hospital care and medicines, medical devices and dietary foods for special medical purposes for home treatment. In 2017, about 27% of the health insurance payments of the fund are for medicines.
According to the Organization for Economic Co-operation and Development, measured as a share of total costs, Bulgaria's spending on medicines is the highest in the EU (over 40%), although in absolute terms (567 euro per person) it is only slightly higher than the EU average (522 euro).
One of the reasons for the constant increase in the cost of medicines in Bulgaria is the expansion of patients' access to innovative drug therapies with the inclusion of new international non-patended names (INN) in the list of medicines intended for the treatment of diseases that are paid under the Law of the Health Insurance. The entry of generics products and the reduction of the prices cannot compensate for the growth rate of costs for the new, expensive international non-patent names.
Public resources for health expenditures are not unlimited. Therefore, it is necessary the Law of the Budget of NHIF to include an analysis of the possibilities for optimizing these costs. Moreover, the public healthcare system is characterized by co-payments from consumers, whose share is highest in medicines - on average about 65%, while in other medical goods and services it reaches no more than 15%, which is close to the level in the most EU countries.
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