European Journal of Biomedical and Pharmaceutical Sciences

HEALTH POLICY AND ACCESS TO DIABETES TECHNOLOGY IN BULGARIA

Mariya Koleva, Nikolina Shishmanova, Petya Georgieva and Mariya Ivanova*

ABSTRACT

Introduction: Medical devices for diabetes management include glucometers and test strips, sensors for monitoring blood glucose levels, insulin pumps and accessories. Every year, the NHIF publishes a list of medical devices by groups that the NHIF pays for in the conditions of outpatient medical care, and the amount up to which the NHIF pays for each group. Aim: To monitor NHIF reimbursement for medical devices and assess the affordability of innovative blood glucose control devices for diabetic patients in Bulgaria. Materials and Methods: A documentary review of the existing regulatory framework regulating medical devices for blood glucose monitoring was conducted. Official data on their financing by the NHIF in Bulgaria for the period 2016-2025 were analyzed. Results: Every Bulgarian patient, diagnosed with some type of diabetes, has access to 16 different types of test strips, 8 types of infusion sets, 5 types of reservoirs for the respective sets, and 11 different sensors for continuous glucose monitoring that are covered by the NHIF. The official List with medical devices gives information about the sum covered by the NHIF for one patient per month. The NHIF has set criteria that the patient has to meet in order to be approved for payed treatment. Conclusion: Not all diabetics can receive payment for the needed devices. The NHIF has a set limit for medical devices reimbursement per month. In many cases, patients have to pay extra for the diabetes technology, which is a financial constraint for some users and hinders access to care for those in need.

Keywords: Diabetes technology, Reimbursment, NHIF, health policy.