The member companies of the Bulgarian Association of Pharmaceutical Wholesalers are sounding the alarm about a potential risk to the accessof cancer medicines for the Bulgarian patients.

In the last month, with the entry into force of some provisions of the National Framework Contract for 2017 and especially their short-sighted and bureaucratic application by the NHIF management, a critical situation has been created in the supply of oncology medicines on the hospital market. It is about the extension of the terms of payment for oncology drugs by the NHIF after the entry into force of the NDA for 2017 by up to 30 days due to checks on compliance with the imposed requirement to link the reported amount of the drug product to the norm and body weight of patients. This has once again placed the pharmaceutical wholesalers in Bulgaria, who have been a financial buffer in the hospital market for years, in a situation of voiceless creditors. And, patients suffering from cancer or malignant diseases are at risk of delayed treatment.

Pharmaceutical wholesalers operate in a highly regulated hospital market that on one hand limits their markup to a minimum and on the other forces them to credit hospitals until the NHIF reimburses them for the medical activities performed. As a result of this system, hospitals’ liabilities and arrears to BAPW and, until the new regulations come into force, exceed the reasonable limit of commercial risk. As of 31st of March 2017, the average arrears to BATEL members was 240 days and the total amount of all liabilities of state and municipal hospitals was BGN 513 million (according to MoH data).

In spite of the difficult financial conditions, the pharmaceutical wholesalers have respected their responsibility to Bulgarian patients in good faith and have therefore not stopped deliveries of life-sustaining and life-saving medicines to date. And in this situation, the NHIF is adding another one-month delay and making this amount swell by tens of millions more! An action that cannot be explained either by control of the funds spent or by the efficiency of a managed budget. And, above all, it cannot be explained by care and thought for patients!

Therefore, BA PW’s members are making a public appeal to review the provisions of the 2017 NDA relating to the supply of oncology medicines. It is an illusion to believe that business can take on more than 500 million leva and is obliged to compensate endlessly for short-sighted government policy. If the problem with payments and the residual period continues, regular delivery of oncology medicines cannot be guaranteed.

The state is once again acting with a bureaucratic-administrative approach instead of using the power of business for constructive improvement in the hospital market. For example, through investment.