Health Systems and Policy Monitor (HSPM)

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Introduction of public coverage for antiviral drugs and antibiotics for children

31 March 2025 | Policy Analysis

Providing free medicines for children is a policy that has been repeatedly brought to public attention by various political and non-governmental organizations in Bulgaria. While medicines for chronic conditions – including those affecting children – are partially or fully reimbursed by the National Health Insurance Fund (NHIF), others, such as antiviral drugs and antibiotics, continue to impose a significant financial burden on families.

The latest attempt to expand public coverage for these medicines occurred in late February 2025, when a coalition of 22 NGOs urged policymakers to address the issue. In a letter addressed to the Parliamentary Commissions on Health and on Budget and Finance, the Ministry of Health, and the NHIF, the coalition proposed allocating funds in the 2025 NHIF budget to cover antibiotics and antiviral medications for children. To support their proposal, they provided findings from a recent study that examined household expenses and financial burden. The study, drawing on a sociological survey and cost data from the NHIF and the National Health Information System, found that one in two parents struggles to afford their child’s medications, with 14.4% facing severe financial hardship. The NGOs also provided estimates of the policy’s impact on the NHIF budget.

The proposal was supported by the parties in the governing coalition and opposition representatives. As a result, the law on the NHIF budget for 2025 adopted by Parliament at the end of March 2025 introduces full reimbursement for antibiotics and antiviral drugs prescribed to children under seven effective from 1 July 2025 (see also the country update “National Health Insurance Fund Budget Grows by 16% in 2025”).

References
Law on National Health Insurance Fund Budget for 2025 (in Bulgarian) https://dv.parliament.bg/DVWeb/showMaterialDV.jsp?idMat=233618

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