OBJECTIVES : To analyze the cost of oncohematology diseases in Bulgaria.

METHODS : Macro costing and micro costing approaches were combined. The official report of the National health insurance fund provided information about the macroeconomic expenditures paid for medicines, ambulatory services, and hospitalizations in 2015-2016. The costs from a patient perspective was analyzed through inquiry containing questions regarding the patients’ demography, type of oncohematology disease, year of diagnosis, and out of pocket expenditures. Descriptive statistic and АNOVA analysis were performed.

RESULTS : During 2015-2016 the number of patients with oncohematological diseases decreased by approximately 3000 people. Less than 30% were hospitalized and the hospitalization cost decreased, but the cost for medicines increased by nearly 1.5 million Euros. Cost for medicines almost tripled the hospitalization cost. 42% of responders reported to have additional expenditures, 22% reported expenditures for diet, change of everyday habits etc., and 36% reported to have productivity loses. 44% of the respondents reported additional payment for medicines for concomitant diseases. Thus the total cost (public funds and patients) account for 34 363 620 Euro.

CONCLUSIONS : Costs for medicines are higher than costs of inpatient treatment, but this tendency is observed in all European countries. The increases in the costs of medicines are compensated by reduced costs of hospitalization. Despite their higher costs, newer medicines are an effective and reasonable investment from a societal perspective. Currently the higher levels of copayment increase the burden on the patients.