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- Title
How Managed Entry Agreements Influence the Patients' Affordability to Biological Medicines—Bulgarian Example.
- Authors
Mitkova, Zornitsa; Manev, Ivan; Tachkov, Konstantin; Boyadzhieva, Vladimira; Stoilov, Nikolay; Doneva, Miglena; Petrova, Guenka
- Abstract
Managed entry agreements are applied in almost all European countries in order to improve patients' access to therapy. The current study aims to evaluate the changes in the affordability of biological medicines for patients in Bulgaria during 2019–2022. The study is a top-down macroeconomic analysis of the key economic indicators and reimbursed costs of biologic therapies. Affordability was determined as the number of working hours needed to pay for monthly therapy. The average NHIF budget for pharmaceuticals increased significantly along with inflation in the healthcare sector. Bulgarian patients had to devote a large part of their income to buying medicines if a co-payment existed. The percentage of the monthly income of pensioners needed for therapy co-payment varied between 10% and 280%. The hours of work required to purchase a package of biologicals varied between 7 and 137 working hours. The global economic crisis has affected Bulgaria and led to worsening economic parameters. There are still no well-established practices to control public spending, as the measures taken to reduce the final cost of medicines mainly affect the pharmaceutical companies. This type of cost-containment policy provides an opportunity for innovative treatment with biologicals for patients with inflammatory diseases. Most of the therapies cost more than the patients' monthly income.
- Subjects
BULGARIA; HEALTH care industry; BIOLOGICAL products; ECONOMIC impact; BULGARIANS; MEDICAL care costs; COST control; HEALTH insurance reimbursement; DESCRIPTIVE statistics; RESEARCH funding; PHARMACEUTICAL industry; PUBLIC spending
- Publication
Healthcare (2227-9032), 2023, Vol 11, Issue 17, p2427
- ISSN
2227-9032
- Publication type
Article
- DOI
10.3390/healthcare11172427