National Health Insurance Fund: The Ministry of Health did not take any measures to ensure cheaper medicines

“The National Health Insurance Fund (NHIF) only pays for medicines, without having an impact on the mechanisms for pricing of medicinal products and the paid amounts,” said in its official statement the management of NHIF. The position was released in response to the warning for new layoffs of Health Minister Stephen Konstantinov. "Everyone who does not perform his/her duties in an appropriate manner will have to leave," Konstantinov said on Saturday. The occasion was the failure of the National Health Insurance Fund to negotiate more attractive prices for the drugs provided.

“The Health Insurance Fund is an independent institution, financing healthcare and operating under the laws approved by the Bulgarian Parliament. It implements the policies of the Ministry of Health,” stated the NHIF’s management team. The institution is not entitled to negotiate the prices and payment levels of any medicinal products, covered by the health insurance contributions of citizens.

The prices and the amounts paid by the NHIF until the end of 2011 were set by two interdepartmental commissions with the Commission on Prices and Reimbursement and the Commission on the Positive Medicine List, which were merged later on. The NHIF had no choice but to pay the amounts, set by the two commissions with the Health Ministry, the Fund stated in its position. Over the last two years, the NHIF has made several proposals for changes that would enable it to negotiate lower prices of medicines, but these were not included in the legislative amendments. As a result, the NHIF may now negotiate only the prices of medicines it pays at 100% and which have no analogues. This is another major problem that prevents it to negotiate discounts for all products, while the current regulations do not provide for a mechanism which could compel companies to participate in the negotiation process and to grant discounts, added NHIF’s team. According to the Fund, had the Health Ministry accepted the proposals, this would have resulted in lower prices of medicines.

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