The digitization of health systems is a topic of immense significance for the modern world. It holds the potential to transform the delivery of healthcare services, enhancing their quality, efficiency, and accessibility. Electronic prescriptions are a key element of this process, but it is crucial to ensure their implementation protects patients’ personal data and privacy. This article examines the digitization of health systems in Bulgaria, with a focus on electronic prescriptions. It highlights aspects of data protection, the potential risks associated with data misuse, and the advantages of electronic prescriptions.

The aim of the study was to analyze the presence of undeclared sildenafil, tadalafil, and vardenafil in food supplements (FSs) for erectile dysfunction. The presence of sildenafil, tadalafil, and vardenafil was determined using the generated ultraviolet (UV)-spectra and mass-spectrometry (MS)-spectra as well as chromatograms produced by the photodiode array (PDA)-detector and ion trap MS-detector. The results were processed by Xcalibur ver. 2.0.7. Fourteen of the 20 analyzed FSs contained undeclared ingredients. Sildenafil was present in 12 of them. Many violations and discrepancies between the label information and the real composition of the FS were identified. 70% of the samples contained undeclared ingredients of an erectile dysfunction medicinal product. The quantities varied within broad limits from 2 mg per tablet to 116.55 mg per tablet. Sildenafil was present in amounts exceeding 16.55 mg that is the maximum recommended dose, thus creating risk of overdose. Besides that, food supplements adulterated with sildenafil analogues are a health risk for consumer’s health as there is no evidence of modified sildenafil toxicity. All analyzed FSs were claimed to be 100% natural, not provoking side effects. No information for any FS contained indications of age limits or risk for interaction with other FSs or medical products.

The administration of an excessive amount of or unnecessary drugs is a prerequisite for numerous drug-related problems, non-compliance, non-adherence to medicinal therapy, exacerbation and poor control of chronic diseases, and failure in achieving the treatment goals. The aim of this study was to assess patients’ awareness on drug use (administration, adherence to drug therapy) and to identify the possible drug-related problems with patients, using 5 or more medicines on Bulgarian territory. The data were collected implementing a structured study tool – a questionnaire for assessment of patients’ therapy using 5 or more drugs prescribed by a physician, including OTC and/or food supplements. The study provided an identification of factors affecting skipping of doses, modification of regime and analyzed the relationships and interdependencies between number of diagnoses and adverse drug effects rate; number of administered drugs and reported problems and unawareness of the medicinal product indications and health state. The results showed that it was necessary to introduce the Medication Review (MR) service in Bulgarian pharmaceutical practice. That will provide possibilities for development of pharmacists’ role in dispensing medical products, it will help in reducing drug-related problems and increasing the effectiveness of the treatment and adherence to medical therapy.

The European Union’s dependence on imports of active pharmaceutical ingredients (API) from third countries has emerged as a critical challenge to the resilience of pharmaceutical supply chains and public health. Over recent decades, the production of API for generic medicines has progressively shifted outside the EU, primarily to China and India, leading to risk concentration and heightened vulnerability during global disruptions. The COVID-19 pandemic and the war in Ukraine further exacerbated the problem, illustrating how geopolitical and health crises can interrupt access to essential medicinal products. This study examines the existing regulatory frameworks and policy initiatives of the European Union aimed at diversifying supply sources, promoting domestic production, and strengthening strategic autonomy. It identifies the root causes of medicine shortages as well as potential risks to the Union’s health systems and economic security. The article underscores the need for a comprehensive and coordinated EU-level approach to ensure the security of medicine supply and to achieve greater resilience in the European pharmaceutical sector.

Introduction: Value-added pharmacy services (VAPS) are additional services to the traditional pharmacy activities, which do not in­clude dispensing of medicinal products and professional consultation. These services have cost reduction effect on the healthcare system and add value to the work of the pharmacist as a healthcare professional. Aim: To assess the pharmacists’ attitudes and expectations towards the remuneration of value-added pharmacy services (VAPS) in Bulgaria. Materials and methods: A cross-sectional study including pharmacists working in community pharmacies was carried out between August 2018 and October 2018. A web-based 15-item questionnaire was developed. The questionnaire was distributed to all members of the Bulgarian Pharmaceutical Union (n=5165). Two hundred thirty-three questionnaires were filled in and returned (response rate of 4.5%). Data were processed by SPSS v. 24.0. Results: Over 51% of the community pharmacies in Bulgaria offer VAPS, mainly measuring blood pressure (67.4%) and blood glucose (12.9%). Over two-thirds of the pharmacists considered charging a remuneration fee for blood pressure measurement irrelevant. About 30.5% of those who held the opposite opinion proposed that the fee charged should not be higher than EUR 2.56. Over 44% of the re­spondents proposed that the fee for blood glucose measurement should not be higher than the same amount. Most pharmacists (98.3%) supported the idea of charging a remuneration fee for injections and influenza vaccination in a pharmacy. Conclusion: The study shows that pharmacists in Bulgaria are ready to offer VAPS, but additional remuneration for the services should be provided.