Reimbursement policy optimization for Angiotensin-converting enzyme (ACE) inhibitors in Bulgaria: Controlling expenditure without undermining access to treatment

Background A reimbursement policy for angiotensin-converting enzyme (ACE) inhibitors based only on controlling expenditure and not adequate for the patient access to treatment could not return expected results for longterm improvement of patients’ health. The study addresses the need for optimization of the reimbursement policy of the National Health Insurance Fund in Bulgaria (NHIF) which is based on payment of a certain percentage of the reference price within an INN group of drugs, i.e. 25%, 50%, 75% or 100% and covers the Bulgarian reimbursement market of ACE inhibitors, related to pharmaceutical expenditure and doctors and patients behaviour.