Treatment patterns, adherence to international guidelines, and financial mechanisms of the market access of advanced breast cancer therapy in Bulgaria

Karanyotova, Stephanie; Topova, Branimira; Petrova, Elina; Doychev, Peter; Kapitanska, Eliana; Petrova, Guenka; Mitkova, Zornitsa; Dimitrova, Maria

doi:10.3389/fpubh.2023.1073733

Cited by 3 publications

(1 citation statement)

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“…Our research indicates that the Bulgarian market for cancer ODs shares similarities with other innovative but non-orphan cancer medications. Access to all cancer drugs follows a similar regulatory pattern and challenges [83], resulting in comparable postauthorization delays. However, cancer ODs carry a significantly higher price, mostly attributed to the non-targeted oncological therapies and conventional chemotherapy included in the non-orphan category [84,85].…”

Section: Discussionmentioning

confidence: 99%

Availability and Access to Orphan Drugs for Rare Cancers in Bulgaria: Analysis of Delays and Public Expenditures

Kostadinov,

Popova-Sotirova,

Marinova

et al. 2024

Cancers

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Rare cancers are defined by an annual incidence of fewer than 6 per 100,000. Bearing similarities to rare diseases, they are associated with substantial health inequalities due to diagnostic complexity and delayed access to innovative therapies. This situation is further aggravated in Southeastern European countries like Bulgaria, where limited public resources and expertise underscore the need for additional policy and translational research on rare cancers. This study aimed to explore the availability and access to orphan drugs for rare cancers in Bulgaria for the period of 2020–2023. We cross-compared data from both the European Union and national public sources to evaluate the number of available and accessible orphan drugs for rare cancers, the delay from market authorization to reimbursement, the dynamics of public expenditures, and regional disparities in access across the country. We juxtaposed the main characteristics of oncological and non-oncological orphan drugs as well. Only 15 out of 50 oncological orphan drugs that were authorized by the European Medicine Agency were accessible for rare cancer patients in Bulgaria. The median delay between market authorization and inclusion in the Bulgarian Positive Drug List was 760 days. The total expenditures for all orphan drugs for rare cancers amounted to EUR 74,353,493 from 2020 to 2023. The budgetary impact of this group rose from 0.24% to 3.77% of total public medicinal product expenditures for the study period. Rare cancer patients represent a vulnerable population that often faces limited to no access to treatment. We call for targeted European and national policies to address this major inequality.

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Section: Discussionmentioning

confidence: 99%