Bulgaria investigates concentration of medical device public funds

The Bulgarian Commission for Protection of Competition (CPC) has launched an investigation into the concentration of public funds allocated for medical devices and assistive products among a limited number of suppliers. The probe focuses on the rules used by the National Health Insurance Fund (NHIF) to pay for medical supplies, dietary foods for special medical purposes, high-specialized devices, and equipment for people with disabilities.

Data from the NHIF indicates significant financial flows: over 400 million BGN was paid for medical devices during 2024–2025, while more than 1 billion BGN was paid to retailers for assistive devices and equipment for people with disabilities during the same period. Preliminary research by the CPC identified potential issues, including the concentration of resources within a small number of companies, a decreasing number of active firms in the market, and regulatory or administrative barriers to competition.

In certain categories, such as hospital and outpatient medical devices, only three companies receive the largest shares of funding. For assistive products for people with disabilities, the bulk of funding is distributed among approximately ten firms. The CPC has received signals from over ten interested parties regarding market restrictions, excessive regulatory requirements, difficulties in repairing assistive devices, and limitations on patient choice. Some reports suggest that small and medium-sized manufacturers have been pushed out of entire regions.