EKIP Economists: Nearly 80% of Clinical Pathways are Undervalued

Currently, 77% of clinical pathways in the country are valued below their actual fair price, economist Arkadi Sharkov told journalists. Together with Stoyan Panchev, he presented the results of a study by the Expert Club for Economics and Politics (EKIP) during a press conference hosted by the Bulgarian Medical Association (BMA). According to Sharkov, a total of 207 clinical pathways require price increases to reflect actual costs, ensure fairness for healthcare facility employees, and guarantee Bulgarian citizens’ access to quality healthcare.

The economist specified that, in practice, two-thirds of the clinical pathways used in the country are affected, which is a clear sign of systemic underfunding. This forces healthcare facilities to accumulate debt or cut costs, putting the quality of medical care at risk.

According to him, urgent financial corrections are necessary to overcome imbalances and achieve fair valuation of medical services. Estimates show that by 2026, the system will need an additional €1.42 billion. According to Sharkov, given the upcoming elections, members of parliament should direct more serious attention to the healthcare sector. He also emphasized that personnel costs are among the most significant items for healthcare facilities, reaching up to 90% of total expenditures in some hospitals.

For the period 2021–2025, a significant increase in inflation has been reported, reaching 14% in the healthcare sector, noted macroeconomist Stoyan Panchev. According to him, the prices of healthcare services are lagging behind the price dynamics in other economic sectors. Panchev also drew attention to long-term forecasts outlining serious pressure on the social and healthcare systems. According to data from the Organisation for Economic Co-operation and Development (OECD), the old-age dependency ratio is expected to nearly double—from 37% in 2024 to 66% by 2060.

Experts from EKIP are working on introducing a new, more accurate measure of price growth in healthcare, which will account for the rising costs of medicines, medical devices, supplies, equipment, and labor.

The Vice President of the BMA, Dr. Valeri Veselinov, pointed out that the lack of a budget, combined with the increase in the minimum wage and social security income, has led to a 13% increase in costs for diagnostic and consultation centers, placing them in a disadvantageous position. A similar situation exists in hospitals, stated Assoc. Prof. Georgi Todorov, a member of the BMA Board of Directors.

The Vice President of the Sofia Medical Association, Dr. Mihail Mihov, presented the results of a survey among general practitioners, according to which 90% of respondents reported double-digit growth in their total costs over the past year, and over 60% indicated an increase between 20% and 30%.

Despite the serious financial deficit, doctors continue to fulfill their professional duty, stated the President of the Bulgarian Medical Association, Dr. Nikolay Branzalov. He added that the political situation remains unstable and an immediate solution cannot be expected, but expressed hope that concrete steps will be taken immediately after a regular government is formed.