OBJECTIVES: The cost-effectiveness (CE) is a concept where the incremental costs of a new molecule versus comparator treatment has a serious influence on the HTA assessment. The use of cost-effectiveness analysis within the decision making processes in public health is increasing globally. Many methodological shortcomings may limit the results from it’s practical application for the novel treatments, because the choice of a comparator could reflect that ratio. The present study investigated the requirements and the selection criteria of comparator medicines in Bulgaria in comparison to nine Central and Eastern European (CEE) countries to survey and analyze that approach and the different selection criteria.

METHODS: To investigate the requirements for alternative treatment for cost-effectiveness analysis we conducted a review of legislation, guidelines and selected ISPOR pharmacoeconomic guidelines in Bulgaria and 9 CEE countries (Latvia, Lithuania, Estonia, Croatia, Slovak Republic, Slovenia, Hungary, Poland, Romania).

RESULTS: CONCLUSIONS: The results of our review would contribute to assess the comparator treatment policy in CEE for improving the quality of the indicators’ choice in Bulgaria in order to value the assessment of pharmaceutical interventions.