Final Report with Recommendations for Reforming Bulgaria’s Pharmaceutical Sector
| Autor: | World Bank |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
COMMUNICATIONS
INDICATORS WHOLESALERS PHARMACEUTICAL POLICY MARKET POWER PHARMACEUTICAL MANAGEMENT MARKET COMPETITION GROSS DOMESTIC PRODUCT HEALTH INSURANCE WHOLESALE PRICE PROSTATE CANCER PHYSICIANS INFLATION FINANCING IMPLEMENTATION RETAILING MARKET ENTRY SUBSTITUTE MONITORING REBATE health care economics and organizations RATIONAL DRUG USE ADVERTISING PHARMAC DRUG EVALUATION SUBSTITUTION STOCK CRIME DISTRIBUTION MEDICINES ACTIVITIES HEALTH OUTCOMES REBATES PROCUREMENT HEALTH BENCHMARK PRICING CLINICAL TRIALS WHOLESALER GOOD PRESCRIBING PATIENT CHRONIC DISEASES PRICES BREAST CANCER PHARMACEUTICAL EVALUATION PATIENTS PHARMACEUTICAL EXPENDITURE GENERAL PRACTITIONERS RANDOMIZED CONTROLLED TRIALS DECISION MAKING HYPERTENSION MEDICINE SUPPLIER PURCHASING PHARMACEUTICAL SECTOR NARCOTICS PRICING PRICING MECHANISMS PREVENTION PRICING POLICIES REPORTS EXTERNAL REFERENCE PRICING COLD CHAIN RISKS PRODUCTS MARKET SEGMENT MARKET SUPPLY HOSPITALS PHARMACISTS PRICE CHANGES DRUG PRICES LEUKEMIA COMMUNICABLE DISEASES MARKETING DISCLOSURE PHARMACEUTICALS WHOLESALING FEES SOCIAL POLICY DEMAND HEALTH CARE PROFESSIONALS PRICE CONTROLS BRAND RETAIL PRICES ISONIAZID CLINICIANS PRODUCT THERAPIES PRESCRIPTIONS PHARMACEUTICAL INDUSTRY GLAUCOMA DIABETES RETAIL PRICE LIVER CANCER BRAND PREFERENCES ACCOUNTING BUDGETS PHARMACY COST EFFECTIVENESS VALUE CLINICAL GUIDELINES GMP TREATMENT GUIDELINES CHEMOTHERAPY RESPIRATORY DISEASES PRICE COMPARISONS BENCHMARKS INSULIN DRUG SELECTION SUPPLIERS DISTRIBUTION OF PHARMACEUTICALS HEALTH CARE OPPORTUNITY COSTS RETAIL TRADE REGISTRATION SUPPLY CHAIN TURNOVER NUTRITION PHARMACEUTICAL PRICING PRICE ADHERENCE TO TREATMENT TENDERING PRICE ADJUSTMENTS INTERFERON EFFICIENCY WAREHOUSES COMPETITION BRANDS DOSAGE FORMS PACKAGING EXPENDITURES MEDICATION QUALITY OF LIFE MARKET SHARE VACCINES PRICE COMPETITION DISPENSING FEES DRUGS METHADONE STRATEGY INTERNET SALES HEALTH MANAGEMENT FEEDBACK CORRUPTION PHARMACIES TRANSFER PRICES LAWS HEALTH SERVICES RETAIL DRUG FORMULARIES PHARMACEUTICAL MANUFACTURERS OBSERVATION NURSES PHARMACEUTICAL PRICING POLICIES EXPENDITURE GENERIC PRODUCTS |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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