BMI View: Pharmaceutical companies in Bulgaria will face increased pricing pressures from the National Health Insurance Fund (NHIF) as it unveils more cost-containment measures to rein in pharmaceutical expenditure. The NHIF will increasingly leverage its purchasing power to negotiate with drugmakers, and this dynamic will moderate the growth outlook for the country's pharmaceutical sector.
Headline Expenditure Projections
Pharmaceuticals: BGN2.53bn (USD1.72bn) in 2014 to BGN2.71bn (USD1.52bn) in 2015; -7.0% in local currency terms and -11.5% in US dollar terms. Forecast unchanged compared to the previous quarter .
Healthcare: BGN6.10bn (USD4.14bn) in 2014 to BGN6.32bn (USD3.55bn) in 2015; -3.6% in local currency terms and -14.2% in US dollar terms. Forecast revised slightly downwards compared to the previous quarter.
|f = BMI forecast. Source: WHO, National Sources, BMI|
|Pharmaceutical sales, USDbn||1.592||1.718||1.521||1.578||1.727||1.917||2.120|
|Pharmaceutical sales, % of GDP||2.92||3.08||3.25||3.38||3.50||3.60||3.69|
|Pharmaceutical sales, % of health expenditure||39.3||41.5||42.9||43.9||44.7||45.1||45.2|
|Health spending, USDbn||4.045||4.136||3.547||3.591||3.863||4.250||4.688|
Risk/Reward Ratings: In Q1 2016, Bulgaria's Risk Reward Index (RRI) score stands at 55.0 and above the regional average of 49.6, which implies fifth position among twenty countries BMI monitors in this region. The scores take into account the challenges for drugmakers operating in Bulgaria, such as the downward pressure on the prices of drugs and the uncertain political outlook.
A total of 206 clinical trials were conducted in Bulgaria in 2014, reports PMR. Most trials are related to psychiatry, oncology, rheumatology, gastroenterology, cardiology and endocrinology. Bulgaria is framing a national strategy for clinical trials, which will outline the future vision for the development of clinical trials.
A total of 10 hospitals in Bulgaria have been found to be re-selling reimbursed oncology drugs abroad, reports PMR, citing National Health Insurance Fund (NHIF)'s Deputy Chair Dimitar Petrov. Petrov did not disclose the names of the hospitals in question, but the NHIF has announced plans, in light of the development, to place identifying stickers on drug packages to prevent the further misuse of expensive drugs.
Bulgaria's National Health Insurance Fund (NHIF) is looking to raise the reimbursement levels for outpatient drugs and cancer treatment in 2016. The new rules will force marketing authorisation holders (MAHs) to offer discounts to the NHIF in case their products are reimbursed. It will also allow an increase in the NHIF's annual spending on outpatient drugs. Additionally, the NHIF has proposed that MAHs should take responsibility for 80% of the budget overspending, with NHIF assuming responsibility for the remaining 20%.
While Bulgaria will continue benefitting from the continued cyclical upswing in the eurozone, real GDP growth will stay modest over the next few years. Private consumption will continue to be the main driver of growth, while contributions from capital investment and government consumption will remain negligible in the years ahead.
BMI Political View
Rising political fragmentation and parliamentary deadlock will continue to halt Bulgaria's reform process. Due to the slow progress, the European Commission will continue its supervision programme of Bulgaria and disburse only part of the total allocated European Union Structural and Development Funds in the years ahead, hampering the country's growth prospects.
The Bulgaria Pharmaceuticals & Healthcare Report features BMI Research's forecasts for drugs and healthcare expenditure and imports and exports, focusing on the growth outlook for the prescription, OTC, patented drugs and generics market segments.
BMI's Bulgaria Pharmaceuticals & Healthcare Report provides industry professionals, strategists, company executives, investors, analysts and sales/marketing heads with independent forecasts and competitive intelligence on the Bulgaria pharmaceutical and healthcare industry.
- Benchmark BMI's pharmaceutical and healthcare market forecasts for Bulgaria, to test other views - a key input for successful budgeting and strategic business planning in the Bulgarian pharmaceutical and healthcare market.
- Target business opportunities and risks in the Bulgarian pharmaceutical and healthcare sector through our reviews of latest industry trends, regulatory changes and major deals, projects and investments in Bulgaria.
- Assess the activities, strategy and market position of your competitors using our company profiles (including SWOTs, KPIs and latest activity) and competitive landscape tables.
BMI Industry View
An at-a-glance perspective on the latest regulatory developments, key forecast indicators and major corporate developments, covering the prescription, OTC and generics markets. The pharmaceuticals and healthcare SWOT outlines strategic factors that affect the basic assumptions underpinning BMI’s forecast analysis, and taken together with BMI’s political, economic and business environment SWOTs, it gives a complete overview of market climate.
BMI Industry Forecast Scenario
Industry forecasts to end-2019 for all key indicators, supported by explicit assumptions, plus analysis of key downside risks to the main forecasts:
- Healthcare: Total healthcare expenditure (USDbn), healthcare expenditure (% of GDP), healthcare expenditure per capita (USD), hospital beds, doctors, and birth & mortality rates (all per ‘000 population).
- Pharmaceutical Market: Drug expenditure in USDbn, % of GDP and per capita (USD).
- Patented Drug Market: Prescription drug sales (USDbn & % of total sales).
- Generic Drug Market: Generic product sales (USDbn), generic sales (% of total sales).
- OTC Drug Market: OTC sales (USDbn & % of total sales).
- Macroeconomic Forecasts: Nominal and real GDP, % real GDP growth, % private consumption growth, % industrial output growth, % consumer price index, % GDP price deflator, exports, imports, trade balance, current account balance, foreign direct investment, exchange rate against USD, government expenditure and external debt.
BMI’s Pharmaceuticals and Healthcare Risk Reward Index
BMI’s Risk Reward Index provides investors (both national and multinational) looking for opportunities in the region with a clear country-comparative assessment of the market’s risks and potential rewards. Each of the country markets are scored using a sophisticated model that includes more than 40 industry, economic and demographic data points to provide indices of highest to lowest appeal to investors, with each position explained.
A snapshot of key market characteristics, including total size of the pharmaceuticals and healthcare segments, growth drivers, leading therapeutic areas and the competitive landscape
A focus on government healthcare reforms, epidemiological trends, mergers and acquisitions, product launches, market entries, FDI activity, R&D, biotechnology, clinical trials and supply chain issues.
Details of the industry regulatory framework and key legislation covering the licensing of new products/services, pricing and reimbursements, intellectual property, taxation and advertising, as well as analysis of the overall regulatory burden.
The competitive landscape section provides comparative company analyses and index by USD sales and % share of total sales – for the total pharmaceutical sector, as well as the OTC, generics and distribution sub-sectors.
Examines the competitive positioning and short- to medium-term business strategies of key industry players. Strategy is examined within the context of BMI’s industry forecasts, our macroeconomic views and our understanding of the wider competitive landscape to generate Company SWOT analyses. The latest financial and operating statistics and key company developments are also incorporated within the company profiles, enabling a full evaluation of recent company performance and future growth prospects.
*Company profiles are not available for every country. Those reports instead contain information on the current activities of prominent companies operating in the market.