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. 2021 Jul 2:9:675277.
doi: 10.3389/fpubh.2021.675277. eCollection 2021.

Analysis of the Household and Health Care System Expenditures in Bulgaria

Zornitsa Mitkova  1 , Guenka Petrova  1
Affiliations

Analysis of the Household and Health Care System Expenditures in Bulgaria

Zornitsa Mitkova et al. Front Public Health. .

Abstract

Health care systems worldwide are experiencing tremendous financial pressure because of the introduction of new targeted health technologies and medicines. This study aims to analyze and compare public and household healthcare expenditures in Bulgaria during the period 2015-2019, as well as present the major cost-containment measures implied by the government and their probable influence on the overall health care cost. Regulatory analysis of the endorsed cost-containment measures, budget analysis of public and household health care expenditures, and their extrapolations were performed. The regulatory analysis reveals that a large number of measures are introduced and valid until January 2021, considering pharmaceuticals, medical devices, and negotiations between the National Health Insurance Fund (NHIF) and Marketing authorization holders (MAHs). NHIF costs due to pharmaceuticals, food supplements, and medical devices are rising from 2015 to 2019. The overall health expenditures average per household and the average per person also grow in this period. The cost extrapolation reveals that an increase in 3-year periods is expected. Despite the implementation of variety of cost-containment measures in Bulgaria, such as HTA, ERP, discounts, and annual negotiations, The National Health Insurance Fund's (NHIF) spending on pharmaceuticals continues to rise in recent years, and further increases are expected in the next 3 years. The average expenditure per household and per person also increased, which confirms the global trend of rising medicine and outpatient services value.

Keywords: Bulgaria; cost containment measures; healthcare expenditure; household expenditures; public expenditures.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Extrapolation of NHIF expenditures to 2022.
Figure 2
Figure 2
Extrapolation of average per household expenditures.
Figure 3
Figure 3
Extrapolation of average per person cost.
See this image and copyright information in PMC

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