site.btaDr Boltadzhiev: Health Insurance Fund Should Purchase Cancer Medications Centrally

Dr Nikolay Boltadzhiev, a member of the National Health Insurance Fund (NHIF) Supervisory Board, told reporters here on Tuesday that he proposes that the NHIF should purchase cancer medications centrally, similar to how it buys medication for home use such as insulin. Boltadzhiev believes that this change would ensure predictability, more control and lower costs, while hospitals would be able to free up funds and halt the re-export of drugs.

Boltadzhiev said that halting re-exports would also stop oncology medication theft. He noted that some hospitals currently take out loans to purchase the expensive drugs needed for cancer treatment and added that his proposal should be discussed in Parliament.

This is not the first time that Boltadzhiev has made this proposal, as he made it before with support from private hospitals' associations in the country.

Acting head of the NHIF Prof. Momchil Mavrov told reporters that such a change would only be possible after amending the law. He added that while in the past hospitals were supplied with medicines for the treatment of oncological diseases centrally by the state. The legal framework was then altered to a system of centralized drug procurement through framework agreements managed by the Ministry of Health, however, this model also proved ineffective due to various legal shortcomings. Mavrov then reported: "For the past four or five years, we have been operating without framework agreements to centrally negotiate the prices of cancer treatment drugs."

This had led to amendments to the Health Insurance Act, which introduced a weighted average price as a mechanism for centralized control over drug prices, Mavrov said. Based on new provisions in the law, a formula for determining the weighted average price was introduced to be applied when paying for medicines in the absence of a framework agreement for the respective medicinal product. In this regard, the NHIF Supervisory Board adopted a proposal to the Ministry of Health to amend Ordinance 10, which outlines the conditions and criteria for the NHIF to pay for medicinal products and devices for people with disabilities. It also covers the negotiation of discounts and the reimbursement of excess funds when applying a mechanism that ensures the predictability and sustainability of the NHIF budget.

The proposal is to have the Ministry of Health allow the payment of drugs that are left alone in a certain group to be excluded from the weighted average formula that pays for oncology medication for hospital treatment, Mavrov said.