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Brussels September 26 th 2012

A correct financing of the healthcare system The main need in order to close the gaps between Romania and Europe. Sorin Popescu ARPIM. Brussels September 26 th 2012. Gaps in Healthcare Financing. Healthcare Budget Allocation (% of GDP). Europe. USA. ROM A NIA. < 4%. Europe. USA.

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Brussels September 26 th 2012

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  1. A correct financing of the healthcare system The main need in order to close the gaps between Romania and Europe Sorin Popescu ARPIM Brussels September 26th 2012

  2. Gaps in Healthcare Financing

  3. Healthcare Budget Allocation (% of GDP) Europe USA ROMANIA < 4% Europe USA Source: EFPIA Report – 2012

  4. Healthcare Budget Allocation in Europe (% of GDP) OECD 2010 ROMÂNIA

  5. Healthcare Budget Allocation in Europe (per capita)

  6. Healthcare Budget Allocation in Romania Source:Romanian National Institute of Statistics – 2012 Romanian National Commission of Prognosis – 2012 Romanian Health Insurance House - 2012

  7. Medicines Consumption in Europe (bil. EUR) 62% 118% Europe:538,5 mil.citizens = 228,1 bil. EUR Romania: 19 mil.citizens= 2,3 bil. EUR 3,6% 1% EFPIA – 2012

  8. Medicines Consumption in Europe (EUR per capita) EFPIA Population, 2008: Eurostat Average EU17 €317 Average EU27 €260 - 400% Romanians are even 4 times healthier or 4 times undertreated

  9. Cost Containment Measures

  10. Lowest European Prices for Medicines Imposed by Law The gap increased the parallel trade and decreased the patients access to treatments CEGEDIM

  11. Huge Payment Terms 300 days in the retail system (180 regulated by law) Insolvencies (410 pharmacies), Bankruptcies (210 pharmacies, 2 distributors) Withdrawals from Romania (1 R&D producer) Hidden invoices recently registered Debts over the payment terms Debts within the payment terms Industry credits the system with1,2billion EUR 82% ofdrug consumption 2,5% of State Budget 1% of GDP The Health Insurance House did not update the exchange rate for dialysis since 2007 and does not pay the dialyses for hundreds of treated patients

  12. Unique Clawback System in Europe 400 mil. EUR in 2012 Deficit 10% 6% 1,8 billions RON 9% 31% 5700 billions RON (imposed by GEO 110/2011) 7,5 bil. RON 6,8 bil. RON 27% 27% Source: NHIH , March 2012 – consumption in retail The impact on producers is 33,2%on their reimbursed income

  13. The new medicines reimbursed in Europeafter 2007 are NOT reimbursed in Romania DELAY of 5,5 years Limited Access to Innovation 85% in Europe < 60% reimbursement rate in Romania > 1700 days of delay 139 new medicines and indications were approved by MoH to be reimbursed but not included yet in the reimbursement list Source: EFPIA member associations

  14. Penetration of Original Medicines in Romania European average: 79,1% Romania: 71,5% Romania has one of the highest generic penetration in Europe Source: EFPIA member associations, 2010 annual report

  15. How Efficient are the “Savings” by Cutting the Expenses with Medicines? Most of the cost-containment measures were applied in the minor segments NHIH 2010 report

  16. Consequences

  17. Most of the Patients are not Properly Treated Statins:                                 12% in Romania vs 27% in Check Acid pump inhibitors:       9% in Romania vs 19% in Poland Osteoporosis 10% in Romania vs. >40% in Slovenia

  18. The Romanian Healthcare System is not “Healthy”Euro Health Consumer Index - 2012 Report

  19. The Romanian Healthcare System is not Progressing Euro Health Consumer Index - 2012 Report

  20. Life Expectancy and Health Spending OECD 2010

  21. Life Expectancy in RomaniaRomanians live 13 years longer than in the ‘70s but still 6,5 years lower than the other Europeans OECD 2010

  22. Conclusions: Health is aninvestment not a cost Romania can close the gaps if correctly invests in healthcare

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