For years, the citizens of Bosnia and Herzegovina have been paying for the most expensive medicines in the region in relation to their standard of living.
The main reasons are unorganized legislation and a single VAT rate of 17 percent. The House of Peoples of the Parliament of Bosnia and Herzegovina has not yet supported initiatives to reduce or abolish the VAT rate on medicines. The turnover of medicines in BiH in 2023 amounted to 961 million marks and is growing year by year, and the market is dominated by foreign producers.
The members of “Iskra” know best how dizzying the prices of medicines and medical devices are in Bosnia and Herzegovina. Cancer patients pay up to 10,000 marks per month in order to survive.
“In the case of innovative medicines, it is up to 10,000 marks. Patients go into debt, take out loans, sell property in order to provide themselves with therapy, who has something to sell. If there is no waiting, patients die and do not wait until they are on the list”, points out Suzana Kekić, president of the Association of Women Patients with Cancer “Iskra” for BHRT.
The Agency for Medicines of BiH says that the reduction in medicine prices would occur if the VAT was reduced or a differential retail margin was introduced, the amount of which is determined by the entity ministries of health. For medical devices, there are no margin restrictions and prices are formed freely.
“When it is said that the prices of medicines are higher compared to the environment, it mainly refers to Serbia. Serbia has much lower prices. When we calculate the maximum wholesale price, we take Croatia. Most of our medicines are cheaper than in Croatia. We have to take care that the producers are paid and that we have medicines on the market”, says Tijana Spasojević-Došen from the BiH Medicines Agency.
Pharmacists point out that medicines are more expensive in Croatia and Slovenia and that they have higher, but graduated margins. Higher margins on cheaper drugs and smaller margins on more expensive drugs.
“Margins in Bosnia and Herzegovina are not unique, but different by entity. In the RS, the maximum margin is 18 percent when we talk about medicines that are bought for money, in the Federation of Bosnia and Herzegovina it is 25 percent, with the fact that it must be known that the margin is the main source of the pharmacy’s income”, says Zahida Binkaj from the Chamber of Masters of Pharmacy of the Federation of Bosnia and Herzegovina.
Journalist Uroš Vukić, who researched the drug market, believes that to calculate the price of drugs in BiH, instead of Slovenia, the Medicines Agency should use other reference countries with a similar income level as in BiH, such as North Macedonia or Bulgaria.
“The basic document that defines the price of medicines in BiH is the Rulebook on Prices, which BiH was the only one in Europe that did not have until 2017. This was the result of lobbying by the pharmaceutical industry, and now that it has been adopted, it favors drug wholesalers more than the countries of the region,” Vukić points out.
In contrast to BiH, countries in the surrounding area have a general and a special tax rate by which medicines are treated. The tax rate for medicines in Bosnia and Herzegovina is the highest in the region, even three times higher than in Croatia and North Macedonia, they write Independent newspaper.
