INTRODUCTION: Pharmacoeocnomic (PE) principles have been introduced in Bosnia and Herzegovina (BH) legislation from 2011. Entity Republic of Srpska (RS) finance medicines through Health Insurance Fund (HIF) which is main decision maker on drug reimbursement (RB). In Federation of BH main decision maker for reimbursement is Federal Ministry of Health (MoH) which adopts list for drugs financed through Federal HIF and 10 cantonal HIFs.

AIM: To review current pharmacoeconomic guidelines applicable in BH.

METHODS: Available rulebooks and legislation on drug reimbursement has been analyzed and assessed using Pharmacoeconomic Guidelines Comparative Table check-list published on ISPOR website.

RESULTS: In Federation of BH there are two rulebooks on reimbursement – one for Federal HIF introduced in 2011 (updated in 2012 and 2014) and one for Cantonal HIF RB lists introduced in 2013 (updated in 2019).

In first case PE analysis is obligatory part of documentation. Mainly budget impact analysis (BIA) is requested but also cost-effectiveness. Methodology is not clearly explained. In case of cantonal HIF RB list, PE analysis is supplementary part of submission and focus is on BIA.

In RS rulebook on reimbursement has been introduced in 2018. This is obligatory part of submission and BIA and CEA are requested with detailed explanation of methodology.

CONCLUSIONS: Pharmacoeconomic guidelines are present in legislation in BH but with different importance for reimbursement decision. Methodology of PE analysis in Federation of BH is not clear while in RS it is not the case. Serious revision and updates of available guidelines is needed in order to ensure its application and transparency.