In 2027, the National Health Insurance Fund (NHIF) plans to cover biomarker diagnostics for patients with newly diagnosed oncological diseases. The tests will be included as a hospital medical care procedure, while their number and the prices at which healthcare facilities will receive funding are yet to be negotiated between the NHIF and the Bulgarian Medical Association.
Biomarker tests provide information that helps doctors choose the most appropriate treatment for a specific patient. The current National Framework Agreement provides for two procedures for this type of diagnostics. At present, one is reimbursed at a rate of EUR 25, while under the other, only one test is planned to be financed by the end of 2026.
Funds will be included in the hospital care budget
According to the draft budget for 2027, payments for biomarker tests will be made from hospital care funds under the section for outpatient procedures. A total of EUR 82 million has been earmarked for this area.
In the explanatory notes to the previous budget, the NHIF formulated the expected effect of biomarker diagnostics as follows:
„The introduction of biomarker diagnostics will ensure personalised treatment, with the aim of achieving a better quality of life and prolonging patients’ lives.“The specific conditions for conducting the tests in 2027 are yet to be determined through negotiations between the health insurance fund and the professional organisation of doctors.
Changes in financing
The draft budget provides for medical devices and assistive products for people with disabilities to be paid for from collected health insurance contributions, rather than through funds transferred from the Ministry of Health.
The same mechanism is envisaged for treatment abroad for children and adults, as well as for medicines outside the positive drug list intended for the treatment of children. EUR 44.7 million has been earmarked for these expenses.
The total planned NHIF budget for 2027 is EUR 5.6 billion. Healthcare expenditure is EUR 478 million higher than in the previous year.
An expansion of preventive activities carried out by general practitioners is also planned. New activities targeting the fight against obesity have been planned for children.
Sources: bnrnews.bg