site.btaPharmacists’ Protest over New Payment Rules for Reimbursable Prescriptions Prompts Talks with National Health Insurance Fund, Health Ministry

Inflamed by legal changes chipping away at their income, pharmacies in some parts of the country Thursday held half-hour stoppages and threatened to stop working with the National Health Insurance Fund (NHIF). Protests were reported in the northern regions of Ruse, Shumen and Dobrich, and Stara Zagora, Boagoevgrad and Haskovo in the south.

As part of the action, pharmacies stopped dispensing emergency drugs Thursday from 9:00 to 9:30 a.m.

The pharmacists’ outrage prompted talks of the Bulgarian Pharmaceutical Union (BPhU) with the leadership of the NHIF and the Health Ministry.

The controversial changes were made by the NHIF and concern payments to pharmacies for the handling of fully reimbursable prescriptions.

BPhU President Dimitar Marinov told BTA on Monday that all pharmacies contracted with NHIF will be adversely affected by the changes, as they call 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.

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

In a BTA interview earlier on Thursday, Mavrov explained that the NHIF budget for fully reimbursable prescriptions is about to be used up after a decision of March for increasing the level of reimbursement of medicines for cardio-vascular conditions. He said that the budgetary effect of the decision “appears to have been miscalculated”.

The NHIF budget for payments to pharmacies for fully reimbursable prescriptions this year is just over BGN 36 million. That is 11% more than in 2023.

The controversial revisions in the payment rules were discussed on Thursday at a meeting of the leadership of the NHIF, the Health Ministry and BPhU. NHIF acting chair Momchil Mavrov told the press that the NHIF and pharmacies are considering “a concensual solution”. “Everybody understands that if no solution is found, a couple of months from now the NHIF will be unable to pay to the pharmacies. We have limited resources and they are nearing depletion,” he said.

BPhU President Marinov said that dialogue with the three organizations has been constructive.