A stagnating private sector and inadequate government policies provide for poor perspectives of Bulgaria’s pharmaceutical market, according to a report of Business Monitor International.

“BMI considers Bulgaria to be among the less attractive pharmaceutical markets in Emerging Europe, a view largely enforced by poor market dynamics and prolonged economic difficulties. In BMI's Pharmaceuticals & Healthcare Business Environment Ratings for Q310, Bulgaria ranks 16th of the 20 markets surveyed,“ the report states.

BMI points out that even though it dedicates the third highest proportion of GDP to pharmaceuticals in the region, Bulgaria's percapita spending remains below average, limiting opportunities for manufacturers of higher-priced products, and that Bulgaria's growth profile is also fairly limited in scope over the next five years.

“As one of the last economies in emerging Europe to enter recession, Bulgaria will also be one of the last to exit the downturn, with a further year of decline on the way in 2010. Even though we expect a return to growth in 2011, we stress that private sector deleveraging, limited scope for fiscal expansion and weaker external demand will prevent economic growth returning to the 6% range seen at the peak of the previous cycle,“ reads the BMI report.

It further points out the fact that Bulgaria’s retail sales fell by 12.9% year-on-year in January 2010. Worsened consumer spending factors are seen as combined with a “persistent effort by the government to reduce prices and its poor contribution to medicine costs compared with most EU countries.“

The BMI actually raises alarm with respect to Bulgarian government’s policies on medicines.

“Amendments to reimbursement levels for drugs included on the country's Positive List see the removal of lower limits for groups of medicines that treat serious diseases. The re-evaluation of reimbursement eligibility and copayment requirements will be increased from twice per annum to six times. BMI considers the proposed changes as a step away from improving patients' access to innovative treatments. Bulgaria currently has the lowest per-capita government spending on pharmaceuticals in the EU, and the highest proportion of out-of-pocket spending at around 56%,“ declares the report of the market analysis agency.

The BMI sees the accumulation of debt in the National Health Insurance Fund (NHIF) as an additional problem in Bulgaria. In May 2010 it was revealed that the NHIF is required to pay more than BGN 60 M to pharmacies in Bulgaria for costs incurred over the previous two months. While BMI considers this fairly minimal at present, any escalation of these debts could cause concern for drugmakers, it says.