How much money do we spend on our health and why do we have to pay the most for medicines? Are we that sick or is the tap in the sector not tightened enough? The topic was commented on in the program “Crossroads” on Nova TV by health economist Arkadi Sharkov from the Expert Club for Economics and Politics.
“Bulgaria is in one of the last places in the European Union in terms of the percentage of gross domestic product allocated to healthcare“, he emphasized in relation to the growing costs of medicines and the financial condition of the healthcare system.
According to him, the country allocates about 5% of GDP for public healthcare, while the average level in Europe is between 8% and 9%. Total funding reaches about 8.5% of GDP, with the difference coming directly from households' pockets.
„However, we are in first place in the European Union in terms of co-payments from citizens' pockets. About 36% of the costs in the system are direct payments from citizens“, Sharkov pointed out. He emphasized that this burden has continued to grow in recent years against the backdrop of global economic instability caused by the COVID pandemic, the war in Ukraine and tensions in the Middle East.
According to him, the US policy regarding tariffs and trade conflicts also has an additional influence. „The US administration wants to reduce drug prices in the US, and the market there is unregulated. This means that this pressure must be compensated for somewhere else along the supply chain“, he explained.
Sharkov noted that Europe remains the second largest market for pharmaceutical companies, but prices are strictly regulated. “Sooner or later, Europe will be faced with the question of whether it is ready to pay for innovations the price they cost, or will give up part of its access to them at the expense of the American market, which is more profitable for pharmaceutical companies“, the expert also said.
On the topic of inflation, he pointed out that the increase in prices for medicines remains significantly lower than the general inflation. “General inflation is about 6%, while the increase in prices for medicines is only 1.7%. This is due to the strict regulation within the European Union“, Sharkov explained.
He recalled that Bulgaria applies external reference pricing, in which prices are compared with those in 10 European countries, and the lowest value becomes the maximum selling price in our country. In addition, there is also internal referencing between drugs with the same molecule.
Medicines are among the most regulated products on the Bulgarian market. Prices are public and can be checked by every citizen“, he emphasized. Sharkov advised people to use the mobile application “Medicine - Price“, through which the maximum selling price of a given drug can be checked.