The reform would introduce common purchasing rules for all hospitals funded by the national health insurance system and expand centralised drug procurement
Bulgaria’s ruling Progressive Bulgaria party has tabled legislation that requires all hospitals receiving public health insurance funding to conduct public procurement procedures, reviving a long-running reform effort as the country faces legal action from the European Commission over its exemption of private hospitals from EU procurement rules.
The proposed amendments to the Public Procurement Act and the Medicinal Products in Human Medicine Act would eliminate distinctions based on ownership and place state, municipal and private hospitals under the same rules when purchasing medicines and medical supplies.
The initiative comes as Bulgaria is defending itself before the Court of Justice of the European Union after the Commission referred the country to the court in December 2025 for incorrectly transposing EU public procurement legislation.
“There must be equal treatment for all healthcare providers using public resources,” Health Minister Katya Ivkova noted. “The objective of centralised contracting is to ensure the same price for the same medicinal product and to address the imbalances identified in the procurement of high-cost medicines.”
