Abstract
The objective of this analysis is to build a regression cost model towards the data for budget expenditures for rare diseases in Bulgaria and to evaluate the future impact on the health care budget. Four regression cost models were built based on previously published results of the macro costing top down financial analysis of the expenditures for medicines spent by the 3rd party payer. In Bulgaria that is the national health insurance fund (NHIF). The previous analysis covers the period 2010-2013 year and the regression models are forecasting the future expenditures till 2016 year. Four models follow linear regression among the researched variables and expected future changes. The cost of all reimbursed medicines, dietary food and medical devices is expected to reach 703 million of BGN, medicines expenditures are expected to reach 680 million, number of reimbursed medicines is expected to be 2315, and expenditures for rare diseases will reach 96 million of BGN. The number of patients, as well as the budget allocated for orphan drugs is increasing in time, with the addition of the critical fact that the oncology drugs were transferred to the NHIF. This is a positive result based on a number of factors, but also reveals the importance of carefully predicting and allocating the funds needed for orphan drugs. The model analyzing costs for pharmacotherapy shows that these expenses will increase linearly in the next three years, which in turn will put the financial capabilities of the NHIF to the test, as well as limit the access of patients to orphan drugs.
Highlights
The pharmacotherapy of rare diseases engages a lot of financial resources of the affected families or of the community [1]-[4]
A regression cost model was build based on previously published results of the macro costing top down financial analysis of the expenditures for medicines spent by the 3rd party payer in Bulgaria that is the national health insurance fund (NHIF) [3]
In Bulgaria, the financing of pharmacotherapy for rare diseases follows the well-established principles regarding the financing of all other medicines, which increases the risk of under financing both treatments for patients suffering from rare diseases, as well as treatments for regular citizens
Summary
The pharmacotherapy of rare diseases engages a lot of financial resources of the affected families or of the community [1]-[4]. In the last 10 years, because of the EU’s programmes targeted at studies and therapy of rare diseases, many resources were relocated towards treatment, which in turn increased the effectiveness of therapy [5]-[7]. A series of authors have researched the topic of increased expenses for rare diseases as a burden to community healthcare savings funds [10] [11]. Others believe that this rapid increase in spending will be short-term and as such do not threaten the aforementioned funds [5]. Central and Eastern European countries have conducted studies, which recover that the pharmacotherapy need of patients suffering from rare diseases has not been satisfied and they do not have access to their respective treatment [12]
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