The medicines are dispensed only by pharmacies in the hospitals and in dispensary clinics. That forces thousands of patients to travel, sometimes hundreds of kilometres, and make unnecessary expenses to get prescriptions and to receive the medicines.  
During the tenders specific amounts of a certain medicines are negotiated that does not allow any flexibility and adequateness given the dynamics of the illnesses.
The treating doctors are often forced to prescribe not the most suitable to the patient medicine but these that are in stock at the hospital's pharmacy or at the dispensary clinic.  
Due to the holding of tenders and the uncertainty of their results (that can be all or nothing) the pharmaceutical producers can not plan the production and supply of medicines.  
All participants in the discussion expressed their categorical opinion that the existing problems have been there for years and despite the many amendments to the legislation they remain unsolved. Holding of tenders, purchase and distribution of medicines is it fact an economical activity that does not pertain to a ministry. This practice is typical in some underdeveloped Asian and African countries and was rejected a long time ago in the developed European countries.  
The common stand of the participant in the discussion is that all these problems can be overcome definitively only if medicines dispensed now under Regulation 34 are transferred for reimbursement by the NHIF.
From the NHIF a written statement was presented  that the institution has no principle objections to take the reimbursement of these medicines as far as the relevant funds are allotted in its budget and amendments are made in legislation. The same was shared in the written statement from the Chairman of the Parliamentary commission on healthcare d-r Luchezar Ivanov.
As an additional argument it was pointed out that NHIF has a huge financial resource that in the form of a 'transitional remainder' is in an account at BNB and even though the money has been collected from health contributions it is not used for the purpose.  
As far as legislation is concerned the necessary amendments were determined:
Amendment to the Law on medicine products in humane medicine - article 262 (can be done in one day at two readings in Parliament)
Cancellation of Regulation 34 ( a decision of the minister of health is needed)
Amendment to Regulation 38 (the list of diseases in Regulation 34 is copied in Regulation 38 - within the powers of the minister of health)
Amendment to Regulation 10 (entirely within the powers of the minister of health)  
Amendment to the Positive medicine list (the list of medicines under Appendix 3 and 4 is transferred to Appendix 1 with a decision of the Commission on the Positive medicine list with the minister of health)
When the budget is accepted it should be allocated a reduction in the budget of MH and the budget of NHIF should be increased with the same amount in its part for medicines for home treatment.

The current Statement reflects the common understanding and the views of all participants in the held Round table and aims at facilitating the health authorities in finding solutions to the existing problems in the supply of medicines under Regulation 34.