Bulgarian Authorities Launch Audit Over Drug Price Discrepancies
Jerusalem, 14 April, 2026 (TPS-IL) -- Sofia (BTA) – Four state hospitals in Sofia and one each in Plovdiv, Pleven and Varna have purchased 10 of the same medications, but their prices differ significantly. This was told to journalists by Deputy Minister of Health Vladimir Afenliev.
According to Afenliev, an analysis comparing the costs of medicines for some rare diseases in 2024 and 2025, with the medicines being mainly for the treatment of children, shows a sharp increase in payments. The medicines are mainly for the treatment of rare, severe diseases with expensive medicines. These medicines are not included in the Positive Medicines List and are purchased directly by hospitals for a specific patient, he added.
Since the medicines are not on this list, they do not have a registered official price, but most of them have registration in the EU. In Bulgaria, the financing of these medicines is based on a transfer from the Ministry of Health to the National Health Insurance Fund. “The prices of these medicines are not subject to regulation by law in Bulgaria and cannot be optimized or compared, but we have an idea to do so,” Afenliev added.
A certain medication in one hospital was bought for 46,000 leva ($27,700) and in another – for over 150,000 leva ($90,000), Afenliev pointed out. Another medication in one hospital was bought for 23,000 leva ($13,800), and in another – for over 64,000 leva ($38,600). A third medication in one hospital was bought for 8,000 leva ($4,800) and in another – for 36,000 ($21,700). Another medication costing 18,000 ($10,800) leva in one hospital cost 44,000 leva ($26,000) at a different hospital.
Similarly, two state hospitals in Sofia bought one medication for 1,500 leva ($900), and a hospital in Plovdiv bought the same medication for nearly 11,000 leva ($6,600). The most striking case was a medication bought by a hospital in Sofia for 517 leva ($310) and in Plovdiv for over 8,000 leva ($4,800).
“When analyzing the documentation, it seems that the regulatory order has been complied with, but in order to see why these anomalies exist, an audit is already being carried out in these hospitals,” Afenliev said.
The Ministry of Health team, together with the Ministry of Finance, plan to introduce regulatory changes aimed at ensuring some regulation in the pricing of these drugs.
The main conclusion is that by 2025 the state has paid many times more for the same drugs.
According to Afenliev, “changes are being considered to introduce full accountability in the spending of public funds, transparency in the purchase of expensive drugs, and thus equality in the spending of public resources will be achieved. Upgrading the electronic system in real time for reporting in the hospital pharmacy, each purchase and delivery will be registered in real time. We have assurances from Information Services AD that the system will be fully functional in May,” Afenliev said.
In the coming days all purchases of medicines, number of packages, unit price and which hospital purchased them will be published on the Ministry of Health website, he added.
