NHIF adopts new mechanism for drug price discounts

The Supervisory Board of the National Health Insurance Fund (NHIF) has adopted a draft model agreement for discounts and the implementation of a mechanism to ensure the predictability and sustainability of the budget for medicinal products paid in full or in part by the Fund. The agreement will be effective retroactively from January 1, 2026, until the adoption of the NHIF Budget Act for 2026, announced the institution’s governor, Assoc. Prof. Petko Stefanovski, following the Supervisory Board meeting.

According to him, pharmaceutical companies provide price discounts for reimbursed medications, which compensate for costs that were not previously budgeted. He specified that the necessity for the agreement is related to operating under an extended budget and the simultaneous increase in drug prices.

The meeting also reviewed the analysis of hospital and outpatient care activities for 2025, which has already been sent to the Bulgarian Medical Association. A separate analysis for dental care is also being prepared and will be provided to the Bulgarian Dental Association upon its completion.

In parallel, investigations continue into cases where patients were reported as hospitalized but, according to data from the National Revenue Agency, visited gambling halls during their hospital stay. Preliminary analysis for the first half of 2025 shows over 22,000 registered visits to gambling halls made by 3,890 health-insured individuals who were reported as hospitalized during the same period. The NHIF states that appropriate measures will be taken upon the identification of violations.