Unlike other former Soviet bloc countries, which began reform in the early 1990s, Bulgaria only pushed through a set of radical reforms in 1997. By this time, it was clear the highly centralized system had reached a crisis point - black markets offering health care had begun to appear, in lieu of a formalized service.
The reforms introduce a greater aspect of consumer choice, which has allowed for significant improvements in efficiency. However, health care in the country is still considered substandard: in 2006, the Health Minister described it as ìcriticalî. Hospitals are generally poorly equipped and the system is running a large deficit.
In line with its accession to the EU, Bulgaria levies no tariffs on pharmaceuticals.