INTRODUCTION: Pharmacoeocnomic principles have been introduced in Bosnia and Herzegovina (BH) legislation from 2011. Reimbursement of medicines is decentralized between two entities and 13 health insurance funds (HIF) but decisions are made by HIF of entity of Republica Srpska and Ministry of Health of Federation of BH.

There are two different legislation framework in entities specially applied for innovative medicines.

AIM: To analyze experiences and opinion of innovative pharma-industry in Bosnia and Herzegovina regarding implementation of current pharmacoeconomic guidelines.

METHODS: We have conducted survey among 13 innovative pharmaceutical companies in BH on their experiences and perception of pharmacoeconomic analysis relevance in reimbursement process. On-line survey has been conducted among market access responsible persons in MS Forms.

RESULTS: 75% of surveyed consider PE studies are obligatory in RB process especially in RS. For Federation of BH it is not clear which PE analysis is explicitly requested and 67% respond that methodology is not clearly stated in legislation. In RS bot budget impact and cost-effectiveness analysis are submitted, and 50% consider methodology is not clear. 75% consider PE studies are relevant for RB decision and 100% agree these principles should be main decision driver. For 75% this would be clear justification for decisions. For 50% of respondent PE analysis should be conducted for all medicines, 25% for innovative and 25% for biosimilars as well. For 75% academic institutions should conduct such analysis.

CONCLUSIONS: Even almost a decade pharmacoeconomic principles are introduced in legislation still it is not fully implemented. The main reason is poor methodology explanation and not clear decision rules are implemented. There is a huge potential for further improvements in order to increase transparency and more rational decisions in order to improve access to medicines and resources allocation.