site.btaPharmacists Plan Protest over Health Fund Payment Changes, Threaten Contract Terminations

Pharmacists are planning a protest action against proposed payment changes by the National Health Insurance Fund (NHIF), President of the Bulgarian Pharmaceutical Union (BPhU) Dimitar Marinov told BTA on Monday.

As part of the action, pharmacies will only dispense emergency drugs on July 4 from 9:00 to 9:30 a.m. and pharmacists will educate patients about NHIF-funded therapy. Pharmacy owners also intend to notify NHIF about terminating their contracts. Marinov clarified that if pharmacy owners choose to comply with the newly proposed regulations, their businesses may potentially shut down within months, as they cannot sustain solely on the sales of over-the-counter medicines and cosmetics.

Marinov assured that pharmacies would continue serving patients but called for public patience and understanding during the half-hour event.

"The Health Ministry has published proposals for changes to the Regulation on the conditions and procedure for prescribing and dispensing of medicinal products for public consultation on its website," caretaker Health Minister Galya Kondeva said earlier on Monday. She added that the Health Ministry has not yet received an official position by the BPhU.

The draft proposes removing the current limit of three medications per prescription for treating up to three different diseases. It suggests that electronic prescriptions could be partially filled at various pharmacies or in segments over time within the prescription's validity. Under the new guidelines, if a patient obtains medication from multiple pharmacies, NHIF would reimburse each pharmacy proportionately, which crucially differs from the current model of paying pharmacies for each processed fully funded prescription.

Marinov explained that all pharmacies contracted with NHIF will be adversely affected by proposed changes, as it calls for significant reduction in payments from the NHIF. This adjustment may lead to pharmacy closures, especially in isolated areas, reducing access to medications for patients.

"We had previously suggested that NHIF adopt a "per diagnosis" payment model for pharmacies to ensure sustainability. However, the implementation of this model is hindered by the lack of access to necessary NHIF data," Marinov explained.

The anticipated amendments to the proposed regulation could enable NHIF to reduce monthly costs by approximately BGN 1 million.