"The Bulgarian Medical Association actively participates in digitization. We are extremely worried when something is done in the wrong way and in violation of the rights of certain groups of the population, including medical doctors, because this would lead to a failure for the digitalization strategy. On October 16, 2023 the ban on issuing paper prescriptions for antibiotics came into force, and since then Bulgarian medical doctors have issued 204,230 prescriptions, with a compliance rate of 66%, and 14,164 cancellations.
This was stated by the chairman of the Bulgarian Medical Union, Ivan Madzharov MD, during a press conference on the topic: "Why then the introduced electronic prescription will not limit the sale of antibiotics and will not be successful in the fight against antibiotic resistance?", reported BGNES.
"Before October 16, 2023, 44,000 electronic prescriptions were issued," added MD Madzharov.
He explained the difficulties faced by medical doctors in issuing electronic prescriptions. "MDs who are not registered as a medical facility do not have the option to issue prescriptions. These are 70% of doctors. A free mobile application can only be used if you have a registered medical facility and an electronic signature, because there is no other way to generate a QR code", he explained.
MD Madzharov commented that only 2,938 out of 3,380 pharmacies filled the so called "white prescriptions", and asked what was happening with the remaining 442 pharmacies he commented: "The monitoring and control of medicinal preparations in our country is practically at the moment only at the level of writing a prescription",
The chairman of the BMA indicated that they insist on returning the parallel use of the two types of prescriptions. "Restoration of the parallel use of paper and electronic prescriptions should be for a certain period of time. During this time, the paper prescription must be uploaded by the pharmacist to the National Health Information System (NHIS) and stored after its execution," he insisted. In addition, the BMA insists on the introduction of effective control by the state of the delivery and stock availability in the pharmacy network in order to realistically compare allocated and available medications.
The Deputy Chairman of the Bulgarian Medical Association, MD Nikolay Brunzalov, explained the difference between the free sale of drugs and those that are under the National Health Insurance Fund (NHIF).
"The electronic prescription under the NHIF was introduced first as an electronic document that is exchanged between different institutions without paper. The BMA and all doctors actively participated in this process, and it was implemented first, but there is one very big difference. First, in this type of medication dispensing the patient visits the doctor, signs the outpatient list, and goes and collects the medication from the pharmacy, the NHIF pays the pharmacy the price of these medications or the difference only when it is fulfilled exactly. When medications are prescribed in this electronic, as we called it a "white" prescription, there the patient pays the appropriate amount and leaves. Here the due control remains only there, it happens in the pharmacy. Of the 15,000 electronic prescriptions, which are currently issued mainly for the treatment of diabetes and antibiotics, up to October there were 800 inspections, and they were definitely not aimed only at the method of dispensing.The difference between the electronic prescription under the National Health Insurance Scheme and this one is mainly in the lack of control in the second type. We are for absolute control and transparency," he pointed out. /BGNES
