site.btaElectronic Invoicing of Expenditures for Unregistered Medicines Begins July 1

Starting July 1, electronic invoicing will be implemented for expenditures related to the use of medicinal products not registered in Bulgaria, National Health Insurance Fund (NHIF) Director Stanimir Mihaylov told reporters after a meeting of the NHIF Supervisory Board on Wednesday. According to him, the supervisors have approved the concept for the terms and conditions under which a contract will be signed between medical facilities that administer medicinal products under Article 266(a) of the Medicinal Products Act and the NHIF.

The Act stipulates that when there is no alternative treatment for a given disease in the country, a medicinal product that is authorized for use in an EU Member State, authorized for use under this law, but not distributed on the Bulgarian market, may be administered to a specific patient.

Electronic invoicing is a step toward transparency and clarification of the process for reporting and paying for these medicines, Mihaylov added. When asked whether there is data from the inspections that began in seven state hospitals, which had purchased the same medicinal products but at prices varying several-fold, Mihaylov noted that this information must be published by the Health Ministry.

Deputy Health Minister Petar Gribnev told reporters that this information is currently being analyzed and will be published once it is ready.

On April 14, Deputy Health Minister Vladimir Afenliev told a briefing that an internal analysis covering 2024 and 2025 identified significant discrepancies in the prices paid by several hospitals for the same medications, many of which are used to treat rare and severe illnesses in children. He added that in some cases the differences were dramatic, for example one hospital purchased a specific medicinal product for BGN 46,000, while another bought it for over BGN 150,000.