For years, citizens of Bosnia and Herzegovina have been paying the most expensive medicines in the region in relation to their standard of living. The main reasons are the unregulated legal regulations and the 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 after year, and the market is dominated by foreign manufacturers.
The members of “Iskra” know best how skyrocketing the prices of medicines and medical devices are in Bosnia and Herzegovina. Cancer patients pay up to 10,000 marks per month to survive.
“If it comes to innovative medicines, it is up to 10,000 marks. Patients go into debt, take out loans, sell their property to provide themselves with therapy, whoever has something to sell. If there is no waiting, patients die and do not wait to be on the list,” points out Suzana Kekić, president of the Association of Women Suffering from Cancer “Iskra”.
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 manufacturers 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 BiH are not uniform, but differ by entity. In RS, the maximum margin is 18 percent when we talk about medicines purchased for money, in the Federation of BiH it is 25 percent, but it must be known that the margin is the main source of income for pharmacies,” says Zahida Binkaj from the Chamber of Pharmacy Masters of the Federation of BiH.
Journalist Uroš Vukić, who researched the drug market, believes that to calculate the price of medicines in BiH, instead of Slovenia, the Medicines Agency should use other reference countries with a similar income level to BiH, such as North Macedonia or Bulgaria.
“The basic document that defines the price of medicines in BiH is the Regulation on Prices, which BiH was the only one in Europe that did not have until 2017. This was the result of lobbying exclusively by the pharmaceutical industry, and now that they have adopted it, it is more favorable to medicine wholesalers compared to the countries of the region,” Vukić points out.
Unlike BiH, neighboring countries have a general and special tax rate according to which medicines are treated. The tax rate for medicines in Bosnia and Herzegovina is the highest in the region, three times higher than in Croatia and Macedonia, BHRT writes.
