News and Media

The four ruling coalition parties reached a consensus to record in the Health Insurance Act that those Bulgarians who want to be treated under the National Health Insurance Fund will have to pay health insurance 5 years back. This was announced by the MPs from the coalition in the past week.

In order to have health insurance now, one has to have all the contributions that were due in the last three years covered. One is permitted to have three unpaid contributions. By introducing changes to the law, the Health Minister Dr. Peter Moscow has required defaulting payers to transfer all amounts due since the creation of the Health Insurance Fund in 2000 up to now, in order to have their health rights restored.

Senior magistrates, doctors and patients attacked the idea, arguing that the maximum period for back payment cannot exceed 5 years. They insisted the new period to fit the maximum. So in mid-April, the Reformist Bloc MPs filed a motion for 5 years’ insurance back payment.

“We will support the proposal of the Reformist Bloc “, said Dr. Daniela Daritkova (GERB), head of the Health Committee yesterday. The parties Alternative for Bulgarian Revival and the Patriotic Front were of the same opinion.

“We have put forth a similar proposal, according to which, if the amounts due for the last 5 years exceed BGN 150, they can be paid back in installments,” said Dr. Sultanka Petrova  from the Patriotic Front.

The Ministry of Finance did not agree. The institution of Vladislav Goranov did not support the proposal of the Reformers that government officials should pay for their own health insurance, as opposed to the situation now – the state paying for it. The reason was that such a change had to pass through tax laws and to be provided for in the annual budget.

Unexpected Effect

Since the Health Minister Dr. Peter Moscow announced his idea that Bulgarians should pay “tax” for their health obligations 15 years back, the revenues from contributions have increased, showed a notification from the NRA. This was emphasized by MPs from GERB. According to them, discussing the change, although it was not in line with our legislation and could not be accomplished, produced a positive effect.

The administration of exemestane significantly reduces the incidence of invasive breast cancer in postmenopausal women with moderately increased disease risk, showed the results of a study published in the New England Journal of Medicine.

Estrogens are involved in the normal mammary glands development, but their high circulating levels may increase the likelihood of breast cancer. Currently, the chemoprevention of breast cancer has been focused mainly on the selective estrogen receptor modulator (SERM) tamoxifen and raloxifene, which have anti-estrogenic effects.

Aromatase inhibitors suppress the estrogen levels in postmenopausal women and reduce the development of breast cancer in laboratory conditions. During the early research in this field, the non-steroidal and steroidal aromatase inhibitors reduced the development of contralateral breast cancer to a great extent, when compared to tamoxifen.

For example, after five years’ treatment with tamoxifen, the administration of letrozole reduced the risk by 46%, as compared to placebo. Preclinical models and clinical trials have demonstrated that exemestane is a good candidate for this indication.

The study MAP.3 was an international, randomized, double-blind and placebo-controlled study. It included 4560 postmenopausal women with a mean age of 62.5 years with some of the following risk factors: age> 60 years; five-year risk score on the scale of Gail> 1,66% (1,66% risk of developing invasive breast cancer in the next five years); previous ductal or lobular hyperplasia or lobular carcinoma in situ; ductal carcinoma in situ with mastectomy. Patients were divided into the following groups: exemestane 25 mg plus placebo; exemestane 25 mg plus celecoxib; and placebo plus placebo.

After the three years’ follow-up period it was demonstrated that the administration of exemestane was associated with a significant (65%) breast cancer risk reduction in the tested groups.

Exemestane had reduced the incidence of precancerous lesions as well (ductal carcinoma in situ, lobular carcinoma in situ, atypical ductal hyperplasia, and atypical lobular hyperplasia) which would have most likely lead to a further reduction of the invasive cancer in the long term.

This is the most significant disease risk reduction in the four largest breast cancer prevention studies. In the previous studies, tamoxifen and raloxifen reduced the disease risk respectively 50% and 38% after five years of follow-up. Subsequently, both drugs were approved by the FDA for breast cancer prevention in women with increased disease risk.

Experts hold the opinion that exemestane is a new opportunity for breast cancer prevention in postmenopausal women.

The analysis results show a favorable safety drug profile for this indication. The frequency of osteoporosis, cardiovascular complications and bone fractures were similar in the groups on exemestane and placebo.

For the three-year follow-up period 30% of those surveyed stopped taking the drug because of side effects, which was similar to thе clinical practice observations of aromatase inhibitors as an adjuvant therapy for early breast cancer.

Subgroup analysis showed that even with the intake of calcium and vitamin D, women treated with exemestane had lower bone mineral density (BMD) during the second year of treatment.

Based on the results of MAP.3, exemestane was included in the new practical guidelines of the American Society of Clinical Oncology in 2013 with the following indication: “Exemestane (25 mg per day orally for five years) should be considered as an alternative to tamoxifen or raloxifene for reducing the risk of invasive, positive for the estrogen receptor (ER +) breast tumors in postmenopausal women. The drug should not be administered to reduce the risk of disease in premenopausal women. “

June 14, 2015 marks the 10^th anniversary from the creation of the Department of Cardiac Surgery at the University Hospital “St. Marina” at the Medical University in Varna “Prof. Dr. Paraskev Stoyanov.” For this occasion, on the 12^th  and 13^th of  June, a Conference in Cardiology and Cardiac Surgery will be organized in Varna under the auspices of the Medical University in Varna “Prof. Dr. Paraskev Stoyanov”, the Heart – Lung Association, and the annual meeting Varna – Augsburg.

As a leading manufacturer of generic and patent medicines with a wide range of drugs for the cardiovascular system, Tchaikapharma High Quality Medicines AD will also participate with its own representative stand. There visitors will have the opportunity to learn about the latest developments in the field of cardiology and to obtain detailed information on the current portfolio of the company and our latest products registered on the Bulgarian market.

Prosecutors and medical auditors will audit the hospitals together

“Red Phone” between the Prosecution and the Ministry of Health will fight the attacks on emergency medics. This will create a direct channel of communication between the teams of Sotir Tsatsarov and Petar Moskov. This became clear after a meeting between the heads of the two institutions in the prosecution last week. The aim of the measures is to minimize the attacks on medics and to have effective punishment of those responsible.

According to the health ministry a total of 227 attacks on emergency physicians in the past year are reported. Of those, most – 142 in Burgas. Although the law in such cases is very strict and provides for imprisonment of up to 15 years, it is not applied in practice. Since mid-2013, when the attacks on medics were criminalized, there were only five sentences so far, according to the Ministry of Health. The heaviest of them is a suspended sentence of three years in prison for assault in Shoumen District. Another five cases and proceedings are ongoing. The expectation is that by creating a hot link between the Prosecution and the Ministry of Health the law will be applied more effectively.

Apart from cooperation in support of emergency medics, Tsatsarov and Moskov agreed to cooperate in cases of violations in hospitals discovered during inspections by the Medical Audition Agency. To this end the two agencies will sign a special agreement. It will be drawn up by a joint working group.

Parents are “against” the mandatory vaccines. In an open letter to the state institutions they insist the vaccination calendar to be voluntary.

Within only five days more than 3200 people have signed the petition for voluntary vaccination of children. Parents insist to have the right to decide whether and when to have their children immunized.

“Nowhere in the European legislation is said that vaccines should be compulsory. In Bulgaria, 9 of them are compulsory, we are more Catholic than the Pope”, said the patient’s organization “Together with you”.

In 16 European countries there are no compulsory but only recommended vaccines. In our country if a vaccine is not administered, fines follow and the children have no access to state kindergartens, parents specify. They hope for changes in the Health Act. And if the compulsory vaccination is not dropped out, at least the parents not to be fined.

The pediatricians have different opinion.

“The health culture of our population is still not at a level sufficient to enable individuals to assess the benefits and the negative effect of vaccines,” physicians insist. Professionals remind that the compulsory vaccines are against especially dangerous infections and are not selected randomly. Polio, tetanus, diphtheria – are diseases that have disappeared due to the fact that children have been immunized.