An e-prescription won't make a medicine appear if it's simply not on the market, the Bulgarian Association for Patient Protection (BAZP) has warned. The group has doubts about planned changes to how the state tracks and supplies medicines.

"If a patient first has to get an e-prescription and only then start looking for the medicine they need, we're already too late," said association lawyer Plamen Taushanov.

Bulgaria's Specialized Electronic System for Tracking and Analysis of Medicinal Products (SESPA) collects data on how much of each drug on the Positive Drug List gets delivered and how much gets sold. From this, the system automatically draws up a list of medicines running short. Once a drug lands on that list, it can't be exported from the country for that period. The list gets updated every week based on deliveries and use.

September's lists name dozens of drugs running short, among them heart and cancer medicines, treatments for rare diseases, diabetes drugs and medicines for other chronic conditions.

The association wants to know how much pharmacies order, how much of that actually gets delivered, how much reaches the pharmacy network, and exactly where the shortfall happens. Possible causes include manufacturing problems, as well as trouble with deliveries, distribution, imports or getting the drug to the pharmacy. An e-prescription confirms that treatment is medically necessary — it doesn't put more of the drug on the shelf.

The association says this means the problem only gets caught once the patient has already lost access to their prescribed treatment. For chronic and serious illnesses, even a short break in treatment can have serious consequences. BAZP says it's unacceptable for someone with a valid prescription to have to go from pharmacy to pharmacy, calling around to track down their own medicine — that just dumps the problem onto the patient.

"Patients shouldn't be held hostage to problems further up the drug supply chain," the association said.

Taushanov said the need for medicines in chronic and serious illness can be forecast. BAZP warns that officials shouldn't judge future needs by past sales alone, since treatment that never starts because the drug isn't available doesn't show up in sales figures at all. The group wants officials to track not just how many packs go out, but also how many people need treatment, how many start it on time, and how many have their treatment interrupted for lack of the drug.

The shortages aren't limited to one drug or one type of treatment, the association says. It backs EU efforts to make supply chains for critical medicines more reliable, but insists that any steps taken in Bulgaria must actually help patients. The association wants the system to give early warning and secure supplies — not just log a shortage after it has already hit patients.

BAZP is calling for any new restrictions or requirements to be introduced only after officials have analyzed the data SESPA has already gathered and identified the causes of specific shortages.