Bulgaria is considering legislation that would extend the reach of central medicine procurement and require hospitals using public health-insurance funds to operate under common purchasing rules. The proposal builds on an existing Ministry-led central purchasing system rather than creating one from scratch.
The bill was introduced in Parliament on 16 July by MPs from Progressive Bulgaria and is supported by the Ministry of Health (Министерство на здравеопазването, MZ). It would require private hospitals with contracts with the National Health Insurance Fund (Национална здравноосигурителна каса, NHIF) to use public procurement procedures for NHIF-funded purchases, bringing them closer to the requirements already applying to state and municipal hospitals.
The proposals would also expand central framework contracting for selected high-cost medicines. MZ, acting as the central purchasing body for healthcare, would negotiate framework agreements establishing prices at which hospitals could contract, while hospitals would remain free to obtain lower prices.
The measure follows scrutiny of large differences in the prices paid by individual hospitals for the same medicines. The Commission on Protection of Competition (Комисия за защита на конкуренцията, CPC) separately reported in July that fragmented purchasing of medicines unavailable through normal Bulgarian market supply could produce higher unit prices and weaker purchasing conditions.
The proposal would therefore shift more negotiating leverage towards the national level while retaining hospital-level contracting. If adopted, manufacturers and suppliers could face a more uniform national price benchmark across NHIF-funded hospitals, including parts of the market currently managed through individual hospital procurement.
Source: Ministry of Health
Link: Министър Ивкова: Предложените от “Прогресивна България” промени в Закона за общественитепоръчки и Закона за лекарствените продукти в хуманната медицина въвеждат прозрачност иравнопоставеност при разходване на публичен ресурс (Minister Ivkova: proposed changes to the Public Procurement Act and Medicinal Products in Human Medicine Act introduce transparency and equal treatment in the use of public resources)
Date: 16 July 2026
Source: National Assembly of the Republic of Bulgaria
Link: Законопроект за изменение на Закона за обществените поръчки (Bill amending the Public Procurement Act)
Date: 16 July 2026
Source: Commission on Protection of Competition
Link: КЗК препоръчва мерки за повече прозрачност и ефективно разходване на публични средства придоставка на нерегистрирани лекарства (Commission on Protection of Competition recommends measures for greater transparency and efficient use of public funds in the supply of unregistered medicines)
Date: 9 July 2026
