Банкеръ Weekly



On the fourth year since its start the health reform not only came to a halt but began to move backwards. This is also confirmed by the Programme for National Policy on Medicines for 2003, which the Ministry of Health Care is already drafting with the ambition to present it for approval by the cabinet by end-October at the latest. The haste is necessary because of the framework agreement with the National Healthcare Insurance Fund (NHIF) for next year and the two documents' interrelation.Under the programme, money from the state budget, the municipalities, and the NHIF, shall cover the costs of the cheapest copies of the original medicines, and when it is possible - of Bulgarian-made medicines only. If the ill person wants an imported medicine and is under treatment at home, he will pay for the difference in the price at the pharmacy or will pay the entire price when treated in a medical establishment.Dr. Tatayana Benisheva, Head of the Health care Ministry's Medicine Policy Department, explained that the directors of hospitals would be obliged to stock their warehouses with Bulgarian medicines only. Imported products shall be purchased only in case the medicines have no Bulgarian analogues. Dr. Benisheva believs that in this way each health care establishment would considerably cut down its costs for medicines, having in mind that generic medicines are almost 30% cheaper that the original ones. The measure will be introduced due to the double increase of budget expenses for medicines since 1999. At the same time, their purchase from pharmacies has dropped from 41% to 25 per cent.As it could be expected, the Association of Medicines Importers is not at all pleased with those intentions. So far the Minister of Health Care Bozhidar Finkov has neither presented to the importers the programme's draft, nor has he invited them to discuss it. However, they got a copy of it and by October 9 will prepare and sent to the ministry their stance in written.Such a limitation of imported medicines is iniquity towards foreign producers, Dr. Petya Stratieva, representative of Aventis Pasteur, said. I do not know about such practices in the other European countries. No such differentiation is made in Europe. It's sufficient for the medicines to be produced on the continent where all manuafacturers are tretaed on an equal footing, she pointed out.Doctors in some big hospitals are also strongly opposing the idea of treating their patients with Bulgarian medicines only. The Executive Director of Pirogov Assoc. Prof. Spas Spaskov qualified the Programme for National Policy on Medicines as relapse of health care to socialist times. He recalled that till 1990 all medical establishments used to be stocked with Bulgarian medicines, and only the patients of Governmental Hospital enjoyed the privilege to be treated with imported medicines. We cannot deprive the patients of good-quality medical aid by giving them medicines of inferior quality and at the same time want our medical treatment to be at the European level, he is adamant. According to his calculations, the prepared measure will not result in any significant economizing at Pirogov. The costs for medicines will be reduced from the current BGN6MN to BGN5.5MN.The Director of the University Hospital St. Anna Assoc. Prof. Dimitar Dimitrov is also convinced that the quality of emdical treatement would worsen if only Bulgarian medicines are used. And Minister Finkov's experiment might even turn out more expensive, he added. Some imported medicines are more expensive but a dose of them is enough for a whole day, while the cheap ones should be taken four or five times a day, Mr. Dimitrov specified.The Bulgarian Doctors' Union also opposed the treatment with Bulgarian medicines only. Within a week the organisation is expected to present its stance to the Health Care Minister Finkov. Balkanpharma, on its part, commented that the new policy on medicines would contribute to the development of the Bulgariam phamaceutical industry and the country will benefit from it.

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