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Sale of antibiotics in Bulgaria fell with digital prescriptions

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The sale of antibiotics in Bulgaria fell by nearly 35% after introducing digital prescriptions, which led to greater control over these drugs, Deputy Minister of Health Ilko Getov told parliament on Monday 23 (October).

Before introducing digital prescriptions, the health ministry announced that reducing their use even by 5% would be a great success.

Bulgaria abolished paper prescriptions and obliged doctors to issue digital prescriptions for antibiotics and diabetes drugs on 16 October, as measures against antibiotic resistance and off-label use of diabetes drugs led to severe shortages in pharmacies.

Paper prescriptions allow repeated use and are not subject to control, often leading to the sale of antibiotics without a prescription in pharmacies.

“The data show that Bulgaria has managed to impose normal regulation on the sale of antibiotics; this is our greatest achievement and a step towards reducing antibiotic resistance,” Getov said.

One of the main goals of the Bulgarian authorities is to limit unnecessary intake and self-medication with antibiotics.

At the same time, however, there are some problems with filling digital prescriptions by pharmacies, with 35% remaining unfilled due to various problems, including software, but this percentage is decreasing.

The Bulgarian medical union requested a temporary return of paper prescriptions, as two-thirds of doctors in Bulgaria are discriminated against for not having access to the electronic system of the Health Ministry.

The biggest problem is with emergency room doctors who have not yet installed a mobile app for prescribing drugs from patients’ home addresses.

The chairman of the health commission in the parliament, Kostadin Angelov (GERB), commented on 23 October that if even one patient in Bulgaria did not receive his medicine, this is a problem.

He called for a quick reduction in the number of unfilled digital prescriptions, which also happens due to a lack of the prescribed antibiotic in the pharmacy network.

“We need software that monitors stock on the market and can see at any moment what drugs we have in the country. We want to know how many packages there are in the country so that when a doctor prescribes a drug, he knows it is available in pharmacies,” said Angelov.

He called on the government to take measures against “pharmaceutical substitution” when pharmacists change the medicine prescribed by the doctor because it is not in stock.

“There are pharmacists who work in good faith, but there are also those who will work as ordered by their owner, who is also the manufacturer of the corresponding medications,” commented Angelov.

Ombudsman Diana Kovacheva said she had received many complaints from patients, doctors and dentists in the past week following the introduction of digital prescriptions.

She criticised the authorities for lacking an information campaign to prepare pharmacists, doctors and patients for the switch from paper to digital prescriptions.

Kovacheva added that the uncontrolled prescribing and dispensing of drugs is a problem in Bulgaria, but the health system was not ready to switch to fully electronic prescriptions” for antibiotics.

A Eurobarometer survey published at the end of 2022 showed that 33% of Bulgarians have taken antibiotics in the last year, and 13% admit that a doctor did not prescribe the medicine.

This is possible because paper prescriptions do not allow control over sales. Only Malta (42%) and Luxembourg (36%) show a higher proportion of people using antibiotics.

(Krassen Nikolov Edited by Vasiliki Angouridi)

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