AUTHOR=Mitkova Zornitsa , Petrova Guenka 

TITLE=Analysis of the Household and Health Care System Expenditures in Bulgaria

JOURNAL=Frontiers in Public Health

VOLUME=Volume 9 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2021.675277

DOI=10.3389/fpubh.2021.675277

ISSN=2296-2565

ABSTRACT=Health care systems worldwide are experiencing a tremendous financial pressure, because of the introduction of new targeted health technologies and medicines. This study aims to analyze and compare the public and household healthcare expenditures in Bulgaria during the period 2015-2019, as well as to present the major cost-containment measures implied by the government and their probable influence on the overall health care cost.
Regulatory analysis of the endorsed cost containment measures, budget analysis of public and household health care expenditures and their extrapolation were performed. 
The regulatory analysis reveals that high number of measures is introduced and valid till January 2021 considering pharmaceuticals, medical devices as well as negotiations between National Health Insurance Fund (NHIF) and Marketing authorization holders (MAHs). NHIF costs due to pharmaceuticals, food supplements, medical devices are rising during 2015- 2019. An overall health expenditures average per household and an average per person also growth in this period. The costs extrapolation reveals that increasing in 3 years period is expected.
	Despite implemented variety of cost containment measures in Bulgaria, as HTA, ERP, discounts and annual negotiations, NHIF spending on pharmaceuticals continue to rise latest years and farther rising is also expected in the next three years.
	The average expenditures per household and per person also increased which confirms global trend of rising medicines and outpatient services value.