Towards Tomorrow: Transforming Sarcoma Care in Bulgaria

OBJECTIVES: Perform gap analysis in sarcoma patient treatment and develop and propose strategies for improvement in Bulgaria.

METHODS: Qualitative data on sarcoma treatment practices, patient outcomes, and healthcare infrastructure in Bulgaria was collected in collaboration with the association "Together against Sarcoma" in Bulgaria and clinical experts.

RESULTS: The findings indicate that Bulgaria has a treatment guideline for sarcoma. Moreover, the expenses associated with patient treatment and follow-up are predefined and entirely covered by the National Health Insurance Fund. Nevertheless, there is a pressing need of centralization of care in Bulgaria by creating expert center(s) dedicated to the treatment of sarcoma patients, along with a multidisciplinary team with experts from various medical disciplines to collaboratively provide a comprehensive treatment plan for the patients. Despite the treatment options available in Bulgaria, there is a tendency towards delayed medical decision-making and occasional suboptimal treatment choices, resulting in diminished survival rates and compromised quality of life for patients. An exemplary sarcoma patient pathway has been developed in Bulgaria, outlining criteria for specialized treatment centers and the configuration of a multidisciplinary team.

CONCLUSIONS: The analysis has identified several critical areas for improvement in the treatment of sarcoma patients in Bulgaria. While the existence of a treatment guideline and comprehensive coverage of treatment costs by the national health fund are positive aspects, significant gaps remain in the healthcare infrastructure. The absence of sarcoma centers of expertise with multidisciplinary teams impedes timely and optimal medical decision-making, adversely affecting patient outcomes and quality of life. The development of an exemplary patient pathway and a proposed structure for a multidisciplinary team, along with establishing the criteria for dedicated treatment centers, provides a roadmap for addressing these deficiencies. Implementing these improvements is essential to enhance the quality of sarcoma care in Bulgaria, thereby improving survival rates and overall patient well-being.