site.btaUPDATED PM Demands Changes in Regulations to Address Shocking Disparities in Medicine Prices Hospitals Pay

Caretaker Prime Minister Andrey Gurov Thursday expressed concern over what he described as systemic abuses within Bulgaria’s healthcare financing system, where hospitals exploit legal loopholes in order to maximize their profit and not to improve patient care, and demanded changes in the applicable regulations. He was speaking at the opening of the government's weekly meeting, where he also said that with three days to elections, his team remains focused on safeguarding fair vote.

Gurov cited examples showing significant price discrepancies for the same medicines paid by hospitals. In one case, a medicine cost BGN 23,000 in one hospital and BGN 125,000 in another - a difference that is enough to buy a new car. He noted that this disparity concerned just one medication for a single patient, and when that is multiplied across all patients, it amounted to the scale of an entire car fleet. According to him, the most troubling aspect is that such practices appear to be entirely legal under the current system.

Shocking disparities in medicine prices paid by hospitals were made public at a news conference by Health Ministry officials earlier this week.

Gurov added that this happens at a time when Bulgarian patients are ranked first in Europe in out-of-pocket payments for healthcare. "This is not a coincidence, but a system that allows profit to be made from the pain and health of citizens," he commented. In his view, the problem is not only economic, financial, or political, but also moral. "It is a red line that society has said can no longer be crossed. That is why we are here and why there are snap elections in three days. Therefore, if this problem can truly be solved with a single sentence, with a change in one regulation or several regulations, then they must be written, proposed here, and I expect this to happen as quickly as possible," Gurov also said.

At a briefing after the Council of Ministers' meeting, caretaker Health Minister Mihail Okoliyski said that measures have been prepared to address the significant price discrepancies identified in unregistered medications. According to him, inspections have already begun in seven State hospitals, as well as in other medical facilities, due to significant discrepancies found in the prices of so-called off-label medications used in the treatment of children. The inspections cover medical facilities in Sofia and Plovdiv (South Central Bulgaria) and have so far revealed price differences in the tens of thousands of leva for the same medication. The final results are expected to show differences amounting to millions of euro, Okoliyski noted. 

The minister noted that the problem relates to medications paid for through mechanisms of the National Health Insurance Fund (NHIF), where significant price discrepancies between different medical facilities have been identified over the years.

Okoliyski announced that changes are being prepared to two regulations to limit these practices, as well as the publication of complete information on purchased medications, their prices, and the healthcare facilities by the Health Ministry and the NHIF for the sake of transparency. 

He clarified that the NHIF is not an investigative body, but if irregularities are found, the competent institutions will be notified. According to him, such price differences lead to inefficient spending of public resources and limit the ability of more children to receive the necessary treatment.