Bulgarians have paid over 745 million BGN out-of-pocket for reimbursed medicines in 2025

High costs for patients with chronic diseases

In 2025, Bulgarians have paid over 745 million leva (approximately 381 million euros) out-of-pocket for medicines that fall under the reimbursement programs of the National Health Insurance Fund (NHIF). According to data from a study by the Expert Club for Economy and Politics (EKIP), these funds are spent on medications that are partially or fully covered by state subsidies.

Patients with severe and chronic conditions are reporting a significant increase in their monthly expenses. According to citizen testimonies, out-of-pocket payments for medications for heart disease, diabetes, and neurological disorders range from about 30 euros to over 160 euros per month, depending on the therapy.

Insufficient reimbursement of key drug groups

Health expert from EKIP Arkadi Sharkov points out that medicines for the treatment of cardiovascular and cerebrovascular diseases bear the greatest financial burden for citizens. According to him, these groups of medications are insufficiently reimbursed by the state budget, forcing patients to cover a significant portion of the price themselves.

"Bulgarians, suffering most from cardiovascular and cerebrovascular diseases, pay the most specifically for these groups. The medicines that are partially or fully reimbursed in these groups are insufficiently reimbursed," Sharkov commented.

NHIF Position

The National Health Insurance Fund explained that the positive drug list is updated on an annual basis. According to the institution, any potential increase in drug coverage depends on the decisions of the Ministry of Health and the Ministry of Finance, after which the Fund will carry out the corresponding payments.