Bulgaria plans full digitalisation of prescriptions by end 2024

Bulgaria plans to digitise prescriptions for all medicines by the end of 2024, the Health Ministry announced after the initial success of e-prescriptions, which managed to reduce the use of antibiotics by nearly 30% in a short period.

In October, Bulgaria introduced mandatory electronic prescriptions for diabetes drugs and antibiotics to tighten controls on their use. For several years, Bulgaria has had a severe problem with the shortage of medicines for diabetes and is struggling with the excessive use of antibiotics.

“At a meeting with the Prime Minister and the Bulgarian Medical Union, we agreed that by April, we will clean up all the shortcomings of the system for electronic prescriptions for antibiotics,” Minister of Health Hristo Hinkov explained.

The paper prescriptions system has many serious flaws; the main obstacle is not allowing the state to control the purchase of medicines. A paper prescription can be used multiple times and has no expiration date, while a digital prescription can be used only once and is marked as used in a centralised system.

However, the tightening of control also caused problems because Bulgarian doctors have almost no information about the drugs available in the pharmacy network and often prescribe antibiotics that patients cannot find. This causes delays in treatment and many unused prescriptions, which has provoked protests from doctors.

Access restrictions

Research conducted by Euractiv showed that many pharmacies’ access to the central e-prescription system was blocked due to software problems.

Initial problems forced Prime Minister Nikolai Denkov to intervene, and parallel use of paper prescriptions for antibiotics is allowed until the end of March 2024. During this period, work on improving the software is underway, making it more user-friendly for doctors, who had the biggest objections to the introduction of e-prescriptions.

However, this period coincides with the flu season, when the consumption of antibiotics in Bulgaria increases, even though, while they can be helpful in some cases of secondary bacterial infection, antibiotics do not help influenza infection, as the WHO points out.

Moreover, it was the goal of e-prescriptions to reduce their uncontrolled use in the first place, as Bulgaria currently ranks first in Europe for Antimicrobial Resistance (AMR), leaving the country no choice but to tighten control over the use of antibiotics.

Moving towards ePrescription

At the beginning of 2024, Sofia will introduce electronic prescriptions for all prescription medicines in some medical practices so that doctors can provide feedback on possible problems with the system.

The country is also experiencing shortages of other drugs, and at peak consumption, pharmacies run out of essential medicines, such as corticosteroids, to treat widespread infections.

In a comment to Euractiv, the Association of Research-based Pharmaceutical Manufacturers in Bulgaria (ARPharM) called on the government to encourage electronic prescriptions for all types of medicines prescribed by doctors.

In this way, the national health information system will “see” every box of prescribed and allocated medicine, and the state will receive real data on the consumption and health needs of the population.

“It will become clear when a certain medicine is not available in the country, or its quantities are decreasing, and a shortage is forming, so the institutions and all participants in the drug supply system, prescription and dispensing could react”, the executive director of ARPharM Deyan Denev commented.

He added that the choice of a paper prescription should be preserved in some instances when the doctor can’t prescribe an electronic one, but that should be reserved for exceptional situations.

[By Krassen Nikolov – Edited by Vasiliki Angouridi | Euractiv.com]

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