DIABETES IN BULGARIA AND THE NEED FOR HEALTH TECHNOLOGY ASSESSMENT

Background Diabetes mellitus /DM/ is a widespread socially significant disease whose frequency and expenditures on treatment continuously increases. This is a challenge for health care systems and an obstacle for sustainable economic development. Health technology assessment /HTA/ is increasingly applied in all developed countries. Methods Descriptive study design with content analysis is applied on data from accessible national and international databases and publications. The study encompassed the incidence, prevalence, mortality rates and health expenditures on treatment of diabetes in order to support the implementation of HFA. Results and discussions There is no accurate statistics on diabetics in Bulgaria. The national diabetes registry is still not implemented. Bulgarian Society of Endocrinology assessed that in 2013 diabetics over 20 years of age account to 9.6% of the population. About 75% of them have poor metabolic control, resulting in serious complications. European HFA database shows increasing trends in standardized mortality rates. Euro diabetes index 2014 ranked Bulgaria on worst position between 30 European countries. In 2016, the National Health Insurance Fund has paid over 125 million BG lv on treatment of diabetes. These facts underline the necessity of HTA in DM treatment. The first steps started in 2015 with Ordinance 9 of Minister of Health for regulation of requirements, conditions, the structure and functions of the HFA Commission in Bulgaria. Conclusion The information from different sources shows high prevalence of DM and great burden on the national health system. The diabetes registry is of utmost importance for gathering reliable data and has to be introduced instantly together with effective prevention programmes in different age groups. HTA is an effective approach for better use of scarce financial resources and should be applied to DM.  Key words:  diabetes mellitus, prevalence, mortality, health technology assessment, expenditure