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Across Bulgaria, patients and health care providers are facing an unprecedented challenge: essential medicines are increasingly hard to find. In the first months of 2025 alone, 114 drugs disappeared from pharmacies, with over 300 vanishing over the past two years, according to a report conducted by Bulgarian media outlet Trud news.
Oncology patients and those with chronic conditions such as Crohn’s disease or rheumatoid arthritis are most affected, with some therapies lacking alternatives even abroad without consulting local specialists.
According to the Bulgarian Drug Agency and industry experts cited by Trud News, low profitability for certain medications in Bulgaria is a primary reason for withdrawal. “Medications are usually withdrawn for marketing reasons—the price at which they are registered in Bulgaria is unprofitable for manufacturers,” explained Boryana Marinkova, executive director of the Bulgarian Association for Parallel Trade in Medicines.
Parallel imports, regulatory hurdles, and slow processes for bringing unregistered drugs into the country further complicate access. Patients report delays of up to 10 days for essential medicines under special protocols, disrupting ongoing therapies.
Many Bulgarians attempt to source missing medications from neighboring countries such as Greece and Türkiye. However, recent regulatory changes abroad often require local prescriptions or specialist consultations, limiting access. Oncologists note that these obstacles make it nearly impossible to maintain continuous treatment cycles for cancer patients, raising concerns about long-term outcomes.
Amid medicine shortages in Bulgaria, some patients have turned to Türkiye to secure essential treatments. Turkish pharmaceutical exports reached $2.23 billion in 2023, a 121% increase since 2017, demonstrating strong domestic production capacity. The country’s medical tourism sector has also grown significantly, hosting 1.8 million international visitors in 2023 and generating approximately $3.1 billion in revenue.
For Bulgarian patients struggling to find certain medications, Türkiye offers a possible route to access treatments, although local regulations often require specialist consultations and prescriptions. This option has become particularly relevant for patients needing oncology or chronic disease therapies that are unavailable domestically.
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