DYNAMICS IN COSTS AND THE NUMBER OF PATIENTS OF THE FIVE MOST RESOURCE-CONSUMING DISEASES PAID WITH PUBLIC FUNDS FROM THE NATIONAL HEALTH INSURANCE FUND FOR HOME TREATMENT

On a global scale, health care costs are constantly growing, with a large part of them taking up the costs of medicinal products. The trend for the increase in the consumption of medicinal products is due to the following main reasons: the aging of the population, the possibility of medical treatment of more and more diseases and the development of new medicinal products. A challenge for the governments of individual countries is how, with limited financial resources, to ensure access for the widest possible range of patients to the best medicines. One way to contain health care costs is the reimbursement method. At the same time, a guarantee is needed that decisions to pay for publicly funded medicines are based on cost-effectiveness criteria.The purpose of the current study is to track the dynamics of the costs of medicinal products, medical devices and dietetic foods for home treatment and the number of sick health insured persons from the five most resource-intensive diseases, paid with public funds from the National Health Insurance Fund in Bulgaria for 2021 and 2022.Materials and methods: Documentary method - monthly statements of the National Health Insurance Fund for costs and number of patients for medicinal products, medical devices and dietary foods for home treatment, according to the ICD code of the disease; Economical analysis; Medical statistical methods; Tabular and graphical analyzes - to visualize the obtained results.Results and analysis: Based on the results obtained from the study, it is clear that for the observed period the total costs of medicinal products for home treatment reimbursed by the NHIF increased by 11.43%. Of the five most resource-intensive diseases, the disease for which the most public funds are spent on medicinal products for home treatment is Non-Insulin-Dependent Diabetes Mellitus, with neurological complications, and the highest rate of increase in spending in 2022 is Non-Insulin-Dependent Diabetes Mellitus, without complications – with 18.3%.Conclusion: In contrast to the upward trend in the costs of medicinal products, we observe a slight downward trend in the total number of sick persons with mandatory health insurance in 2022 compared to 2021. In the total number of patients for whom public funds were spent on medicinal products for home treatment by the NHIF, the reduction was 0.97%. Despite the general trend, with the most resource-intensive diseases under consideration, the number of patients slightly increased, with the exception of only one of them.