News

23 October 2023

“Why was there no prior information campaign and is it not appropriate to do so now and in the meantime to rectify irregularities by alternative ways of purchasing medicines?” This was the question put by Ombudsman Diana Kovacheva to the Minister of Health at an emergency meeting of the Health Committee at the National Assembly, which was attended by the executive directors of the Bulgarian Drug Agency and Information Services AD.

The reason is the chaos after the introduction of the purchase of antibiotics and medicines for the treatment of diabetes mellitus only with an electronic prescription, which is effective from last Monday, 16 October.

Prof. Kovacheva also asked other questions provoked by the numerous complaints, both from patients and doctors, dentists, veterinarians and pharmacists.

She asked what alternative prescribing options exist for doctors, including adult paediatricians, whom people trust to treat their children, if they do not have the necessary hardware and software or technical knowledge, do not have an electronic signature, do not have a smartphone or good Internet connectivity if they practice in the countryside.

Another question that the Ombudsman did not receive an answer to was whether changes had been made to the mobile application to make it accessible for all doctors, regardless of their place of work, the brand of smartphone and the operating system they have.

Next, Prof. Kovacheva asked what alternative is envisaged for patients who visit a pharmacy where the medicinal product with a trade name prescribed by the doctor is not available, and the doctor cannot be found at the moment or is unwilling or has not indicated any possibility for alternative substitution.

“Why don’t doctors have information about the available drugs in the pharmacy network so that they can prescribe the best product they think is available? Who and how controls in practice the obligation of pharmacists, if the pharmacy does not have a prescribed medicinal product, to provide it within 24 hours and whether it carries out such controls at all, are there any sanctions imposed?”, asks Diana Kovacheva.

Last but not least, the Ombudsman raised questions about the lack and shortage of a large number of medicinal products, including life-sustaining medicinal products, on the Bulgarian pharmaceutical market. As an example, Kovacheva pointed out that following her recommendations to the Minister for Health regarding the shortage of specific medicinal products, including insulins, the citizens and the Ombudsman received the following reply from the Ministry of Health or the Bulgarian Drug Agency: “information was requested and received from the marketing authorisation holder on the quantities imported, while the products are missing from pharmacies and citizens cannot buy them”.

That is why Prof. Kovacheva asks what mechanisms the Bulgarian Drug Agency has in place to effectively control the availability of medicinal products in the pharmacy network and what emergency measures are envisaged in this regard, and what are the reasons and who is responsible for the impossibility of tracking of the medicines along their entire path — from their import into the country to their receipt by the patient — and what emergency measures are envisaged to make this possible in the shortest possible time.

At the hearing, it became clear that the Ministry of Health is planning to add the possibility for emergency doctors and dentists to be able to write e-prescriptions for antibiotics and diabetes medicines.