This is a best prospect industry sector for this country. Includes a market overview and trade data.
Last Published: 9/19/2019

Healthcare Best Prospects

Pharmaceuticals

Overview

                                                 

In 2018 the Bulgarian pharmaceutical market grew by 5.9 percent compared to 2017 reaching USD 2 billion and outpacing other fast-growing markets in the Central and Eastern Europe region. Nevertheless, this was the first registered decrease in growth which has been in double digits for the last ten years. In 2018 we calculate that 3.0 percent of Bulgaria's GDP was spent on pharmaceuticals, well above the historical average. In 2018 a boost to hospital spending on innovative drugs was a key driver of market growth, but this was primarily due to a backlog of demand for innovative medicines.
Bulgaria's healthcare expenditure in 2018 was USD 5.3 billion, equaling a per capita healthcare expenditure of USD 743. Government healthcare spending in 2018 rose by 4.8 percent to USD 2.60 billion, whereas private healthcare spending was upped by 7.2 percent USD 2.62 billion. Government healthcare expenditure as a proportion of total healthcare spending has continued to rise over the previous decade, highlighting improvements in access to healthcare and the development of an equitable healthcare system in Bulgaria. Nevertheless, out-of-pocket expenditure and private expenditure remains high as a proportion of total healthcare expenditure.
Pharmacies & Drug Stores

An ageing population provides pharmacy operators with a growing number of loyal customers and a stable demand. The market is also one of the most consolidated among retail sub-sectors in Bulgaria. The leading chain, Apteka Mareshki, has more than 300 drug stores, and there are three more chains with more than 45 pharmacies, including the only foreign brand, DM Pharma. With Bulgaria's population in mind, there is more room for the market to grow. With several large players already in place, consolidation is likely to follow, as some of the pharmacy chains are big enough to acquire smaller, regional competitors in the medium to long term.
Bulgaria-based distributor of pharmaceuticals Sopharma Trading (part of Sofia-based Sopharma - Bulgaria's second largest drug maker and one of the country's oldest companies) entered the retail market in mid-2017 and has been expanding rapidly ever since. The company has expanded in 10 cities running 56 pharmacies under the Sopharmacy brand. 

Medical devices
Bulgaria represents one of the smallest medical device markets in the EU, which will register a mid-single-digit local currency compound annual growth rate (CAGR) over the 2018-2023 period. The market is largely reliant upon imports which are primarily sourced from other EU member states and the US. Market growth will be dependent upon increasing healthcare funding and the success of efforts to develop the private sector.
Latest Updates and Key Forecasts

  • Some analysts project that the market will expand by a 2018-2023 CAGR of 6.1 percent in local currency terms and by 7.0 percent in US dollar terms to BGN701.5 million (USD447.4 million) by 2023. 

  • The government's ongoing commitment to increasing health expenditure coupled with real GDP growth, should see medical device imports rise in 2019. Imports increased by 0.4 percent y-o-y to USD61.9 million in the three months to February 2019. For the 12-month period ending February 2019, imports decreased by 0.6 percent to USD240.4 million.

  • We expect medical device exports to continue increasing in 2019, although slowing economic growth in key trade partners such as Germany, Austria and Italy will pose a threat to export growth rates. Exports increased by 10.7 percent y-o-y to USD51.6 million in the three months to February 2019. For the 12-month period ending February 2019, exports rose by 21.5 percent to USD207.5 million.

  • Recently approved government funding for child and maternal health will support investment in infrastructure, which will help Bulgaria to raise its key indicators closer to levels found elsewhere in Europe.


E-health & Innovation
There is a strong U.S. presence in Bulgaria of key enterprises providing healthcare solutions for the med-tech industry. The U.S. market share is between 30-40 percent and increasing. Excellent mobile and internet networks are available in the country with high penetration rates, which makes the market very friendly and open to innovation and digital technologies. Intense competition exists, mainly from German and Chinese providers competing on price and delivery. The National Health Insurance Fund (NHIF) administers the resources collected from the mandatory health insurance contributions. Bulgaria’s e-health sector reform strategy encourages modernization and upgrades in a wide range of areas including the demand for telemedicine and introduction of a national health care portal.
Focusing on e-Health, m-Health, telemedicine and big data is outlined in the National e-Health Strategy 2014-2020. Currently the project for the National Health Information System is underway with several tenders announced for various systems with major opportunities for US companies in the following:

  • ERP/EHR/PHR/E-prescriptions management solutions;

  • Telemedicine & m-Health;

  • Pharmacy automation, software and services;

  • Picture archiving and communication system (PACS);

  • Big data and cloud solutions.


R&D and Clinical Trials 
Bulgaria ranks top 20 in the world in clinical trials performed which is valued at USD 300 Million. Bulgaria offers great potential for Contract Research Organizations (CRO).

U.S. enterprises enjoy a market share estimated at 50 percent or USD 150 million and continue to support operations in Bulgaria. Main competitors are German, Swiss and French CROs. There is an active Bulgarian Association of Clinical Research (BACR) with some 135 members that is advocating for high standard in conducting clinical trials and adherence to the requirements of the Bulgarian and international standards.
http://bacr-bg.com/en/About-the-Association

Dietary supplements & sports nutrition

Dietary food supplements is one of the bestselling segments with a steady double-digit growth of 10 percent in the last few years and expected to reach a market size of USD 200 million. Dietary supplements have enjoyed increased popularity over the last five years and represent more than half of overall value sales in vitamins and dietary supplements, with a 55 percent share. The increased popularity of such products is mainly due to the fact that they are seen as natural, harmless and a healthy substitute for synthetic traditional remedies which have the potential for side-effects. The most popular dietary supplements category is probiotic supplements and this category represents a 25 percent share of overall sales of dietary supplements.

Trade events
Bulmedica/Buldental
https://bulmedica.bg/index.php/en/

Web Resources


U.S. Commercial Service Sofia Contact Information
Name:              Milko Minev
Position:           Commercial Specialist
Email:               milko.minev@trade.gov
Phone:              +359-2-937-5145
           

 

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