Final Report with Recommendations for Reforming Bulgaria’s Pharmaceutical Sector

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dc.creatorWorld Bank
dc.date2015-12-08T22:46:56Z
dc.date2015-12-08T22:46:56Z
dc.date2015-05
dc.date.accessioned2026-07-01T00:49:03Z
dc.descriptionThis 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.
dc.formatapplication/pdf
dc.formattext/plain
dc.identifierhttp://documents.worldbank.org/curated/en/2015/11/25465740/final-report-recommendations-reforming-bulgaria’s-pharmaceutical-sector
dc.identifierhttps://hdl.handle.net/10986/23248
dc.identifierhttps://doi.org/10.1596/23248
dc.identifier.urihttp://hdl.handle.net/123456789/411452
dc.languageEnglish
dc.languageen_US
dc.publisherWashington, DC
dc.rightsCC BY 3.0 IGO
dc.rightshttp://creativecommons.org/licenses/by/3.0/igo/
dc.rightsWorld Bank
dc.subjectPHARMACY
dc.subjectCLINICAL GUIDELINES
dc.subjectRISKS
dc.subjectRETAILING
dc.subjectRETAIL PRICE
dc.subjectDOSAGE FORMS
dc.subjectSUBSTITUTION
dc.subjectCHRONIC DISEASES
dc.subjectDISPENSING FEES
dc.subjectACCOUNTING
dc.subjectFEEDBACK
dc.subjectFINANCING
dc.subjectSTOCK
dc.subjectPHARMACISTS
dc.subjectPACKAGING
dc.subjectSALES
dc.subjectPREVENTION
dc.subjectLAWS
dc.subjectACTIVITIES
dc.subjectSUPPLIER
dc.subjectADHERENCE TO TREATMENT
dc.subjectHEALTH INSURANCE
dc.subjectMONITORING
dc.subjectDRUGS
dc.subjectHEALTH CARE
dc.subjectDRUG PRICES
dc.subjectHEALTH
dc.subjectDRUG FORMULARIES
dc.subjectDISTRIBUTION
dc.subjectPRICING
dc.subjectWHOLESALE PRICE
dc.subjectBREAST CANCER
dc.subjectPRICE
dc.subjectBENCHMARKS
dc.subjectRETAIL TRADE
dc.subjectPRESCRIPTIONS
dc.subjectCORRUPTION
dc.subjectCRIME
dc.subjectHYPERTENSION
dc.subjectDISCLOSURE
dc.subjectPRICE COMPETITION
dc.subjectINFLATION
dc.subjectPHARMACEUTICAL
dc.subjectRETAIL
dc.subjectINTERFERON
dc.subjectPHARMACEUTICAL POLICY
dc.subjectRANDOMIZED CONTROLLED TRIALS
dc.subjectPHARMACIES
dc.subjectCOMMUNICATIONS
dc.subjectCOST EFFECTIVENESS
dc.subjectMARKET SEGMENT
dc.subjectWHOLESALER
dc.subjectDIABETES
dc.subjectADVERTISING
dc.subjectMARKET ENTRY
dc.subjectPRICING MECHANISMS
dc.subjectBRANDS
dc.subjectPATIENT
dc.subjectPATIENTS
dc.subjectPHARMACEUTICAL MANUFACTURERS
dc.subjectLEUKEMIA
dc.subjectREBATES
dc.subjectREBATE
dc.subjectPRODUCTS
dc.subjectMEDICATION
dc.subjectNURSES
dc.subjectRATIONAL DRUG USE
dc.subjectPHARMACEUTICAL INDUSTRY
dc.subjectHEALTH MANAGEMENT
dc.subjectOBSERVATION
dc.subjectMARKETING
dc.subjectWHOLESALING
dc.subjectINDICATORS
dc.subjectBRAND PREFERENCES
dc.subjectPRODUCT
dc.subjectGROSS DOMESTIC PRODUCT
dc.subjectPRICING POLICIES
dc.subjectGMP
dc.subjectBRAND
dc.subjectEFFICIENCY
dc.subjectNARCOTICS
dc.subjectEXPENDITURE
dc.subjectPHARMAC
dc.subjectSUBSTITUTE
dc.subjectBENCHMARK PRICING
dc.subjectPROCUREMENT
dc.subjectPRICE ADJUSTMENTS
dc.subjectTURNOVER
dc.subjectPRICE COMPARISONS
dc.subjectVALUE
dc.subjectPROSTATE CANCER
dc.subjectMEDICINE
dc.subjectPHARMACEUTICALS
dc.subjectBUDGETS
dc.subjectSOCIAL POLICY
dc.subjectDEMAND
dc.subjectHEALTH OUTCOMES
dc.subjectPHARMACEUTICAL EXPENDITURE
dc.subjectREPORTS
dc.subjectISONIAZID
dc.subjectDRUG EVALUATION
dc.subjectINSULIN
dc.subjectPRICE CHANGES
dc.subjectEXPENDITURES
dc.subjectDECISION MAKING
dc.subjectTHERAPIES
dc.subjectCHEMOTHERAPY
dc.subjectOPPORTUNITY COSTS
dc.subjectPHARMACEUTICAL PRICING
dc.subjectCOLD CHAIN
dc.subjectNUTRITION
dc.subjectMARKET
dc.subjectRETAIL PRICES
dc.subjectEXTERNAL REFERENCE PRICING
dc.subjectSUPPLY CHAIN
dc.subjectQUALITY OF LIFE
dc.subjectMARKET COMPETITION
dc.subjectINTERNET
dc.subjectTENDERING
dc.subjectGLAUCOMA
dc.subjectDISTRIBUTION OF PHARMACEUTICALS
dc.subjectVACCINES
dc.subjectHEALTH CARE PROFESSIONALS
dc.subjectPHYSICIANS
dc.subjectCOMMUNICABLE DISEASES
dc.subjectMARKET SHARE
dc.subjectCLINICAL TRIALS
dc.subjectCLINICIANS
dc.subjectLIVER CANCER
dc.subjectPHARMACEUTICAL SECTOR
dc.subjectEVALUATION
dc.subjectGENERAL PRACTITIONERS
dc.subjectDRUG SELECTION
dc.subjectSUPPLY
dc.subjectPURCHASING
dc.subjectRESPIRATORY DISEASES
dc.subjectMARKET POWER
dc.subjectMETHADONE
dc.subjectTREATMENT GUIDELINES
dc.subjectWAREHOUSES
dc.subjectGOOD PRESCRIBING
dc.subjectSTRATEGY
dc.subjectWHOLESALERS
dc.subjectTRANSFER PRICES
dc.subjectFEES
dc.subjectPHARMACEUTICAL MANAGEMENT
dc.subjectREGISTRATION
dc.subjectSUPPLIERS
dc.subjectMEDICINES
dc.subjectPRICE CONTROLS
dc.subjectHOSPITALS
dc.subjectHEALTH SERVICES
dc.subjectIMPLEMENTATION
dc.subjectPRICES
dc.subjectPHARMACEUTICAL PRICING POLICIES
dc.subjectGENERIC PRODUCTS
dc.subjectCOMPETITION
dc.titleFinal Report with Recommendations for Reforming Bulgaria’s Pharmaceutical Sector
dc.typeReport
dc.typeRapport
dc.typeInforme

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