Bulgaria is proposing to abolish the National Council on Prices and Reimbursement of Medicinal Products (Национален съвет по цени и реимбурсиране на лекарствените продукти, NCPRMP) as a separate legal entity and move its specialist functions into the Ministry of Health (Министерство на здравеопазването, MZ).
The proposal forms part of a wider administrative restructuring. MZ argues that pricing and reimbursement are closely connected with national pharmaceutical policy and that keeping them in a separate institution creates unnecessary organisational separation. It says the change would improve coordination, transparency and accountability while retaining existing functions and specialist staff.
NCPRMP currently regulates and registers medicine prices, decides inclusion in the Positive Drug List, maintains reimbursement status, performs medicine HTA and undertakes real-world treatment-effect monitoring. It has operated as a stand-alone state commission since 2013.
The proposal has prompted unusually broad opposition. The American Chamber of Commerce in Bulgaria warned that moving NCPRMP into MZ could weaken the independence and predictability of assessment and decision-making and risk delays. Research-based and generic pharmaceutical associations, pharmacoeconomic experts and patient organisations have raised similar concerns.
NCPRMP itself issued an open letter on 31 August calling for a full functional and institutional assessment before its structure is changed. It highlighted its accumulated HTA expertise, digital infrastructure and participation in EU HTA activities.
The proposed model would bring pharmaceutical policy, HTA, pricing and reimbursement administration more directly under ministerial control. Its practical effect will depend on whether the existing expert and collegial decision-making structures are preserved once those functions move inside MZ.
Source: Ministry of Health
Link: Министър Ивкова: Политическият пиар измести фактите за реформата в здравеопазването(Minister Ivkova: political PR has displaced the facts about healthcare reform)
Date: 20 August 2026
Source: American Chamber of Commerce in Bulgaria
Link: AmCham Bulgaria’s Position on Preserving the Institutional Independence of the National Council on Pharmaceutical Pricing and Reimbursement
Date: 13 August 2026
Source: National Council on Prices and Reimbursement of Medicinal Products
Link: Отворено писмо до всички заинтересовани лица (Open letter to all interested parties)
Date: 31 August 2026
