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General Information
February 2011, Bucharest
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ContentContent
Introduction. 3
Terminology . 4
Legal f ramework 5
Medical services market. 6
Public Romanian Healthcare System. 7
Private Romanian Healthcare System... 8
Private Outpatient Medical Center in Romania.. 9
Distribution 10
Most important outpatient medical center in Bucharest.. 11
Private outpatient specialized clinics... 14
Private hospitals in Romania........................... ........ 15
Synoptic table private hospitals in Romania and Bucharest 20
Private hospital location by map21
The major private healthcare companies 2009...22
Public and private insurance system.23
Sources of revenue25
Comparative prices for available medical services in private hospitals in Bucharest26
Observations.27
Conclusions..29
Apendix
List of hospital regulations
The most frequent chances of developing diseases in RomaniaThe major pharmaceutical companies in 2009 Pro EAST Consulting 2011
2
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IntroductionIntroduction
This study provides general information on the Private Healthcare System in Romania in terms of both its
current level of development and its future evolution. It is updated monthly.
The studys methodology is centered on the following criteria:
type of medical unit;
medical specialty;
number of beds;
location;
names and nationality of the shareholders affiliation with any medical companies.
New hospital construction projects are classified also according to: amount of investment, surface and
expected launch date.
Pro EAST Consulting 2011
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Therminology
The various private medical units in operation today can be defined as follows:.
Outpatient Medical Centres (for diagnosis and treatment): provide multi-disciplinary ambulatory medical
services. They are currently equipped with laboratories for blood and fluid analysis and will eventually be
equipped with diagnostic imaging devices (CT, Rx, ultrasound or MRI)
Outpatient Specialized Clinics: are medical centres that specialize in a single medical discipline or ailment
such as Ophthalmology, Plastic Surgery etc. They are equipped with the required laboratories and will
eventually acquire the diagnostic imaging devices needed in support of their respective speciality. Patients can
remain hospitalized at the clinic for a maximum of 24 hours.
Specialized Hospitals: are classified as hospitals but with a single principle specialty and as many as two
adjacent specialities (eg.Obstetrics and Gynaecology). Patients can remain hospitalized for periods of greater
than 24 hours. These are hospitals and are therefore equipped with an ICU and Emergency Room services. A
classic example would be a Obstetrical and Gynaecology Hospital.
General Hospitals= provide the full range of medical services for several medical specialities including the
following units: ER, Outpatient, Internal Medicine, Surgery, ICU, and eventually Maternity. General Hospitals
are fully equipped with laboratories and radiology devices. . They have laboratories investigation
departments and imagistica (radiology).
Pro EAST Consulting 2011
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5
Legal framework
All Hospitals, Medical Centers and Outpatient Clinics, both private and public, are governed by and must
operate in accordance with Romanian law (specifically Law 95/2006 as last updated on 07 Oct 2009).
In addition, the construction and operation of hospitals in Romania are governed by the Ministry of Health
(Order OSMP 914/2006 last updated by1030/2009) Please refer to Appendix 1 for more detailedinformation.
Last but not least, all medical and non medial units of a hospital must be compliant with, and managed
in accordance with, the standards of the European Union.
Medical Services provided by either Public or Private medical units in Romania are VAT exempt.
Romanian legislation permits the establishment of Private General Hospitals and Medical Clinics under Law
No 31/1990. This legislation equally applies to private sector companies.The Administrator and at least
one third of the Board of Directors must be qualified doctors. There is no such restriction on shareholders.
5
Pro EAST Consulting 2011
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Medical Services MarketMedical Services Market
The Government of Romania currently allocates 5 % of GDP to the Healthcare Sector which is very low
when compared with the average percentage of GDP allocated in East Central European (6,7% of GDP)
or Western Europe (9,8% of GDP).
The market for private medical services is estimated to have been 430 million Euro in 2009; a 35%
increase over 2008. The rate of growth for 2010 is projected to be at least 20%.
Pro EAST Consulting 2011
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Public Romanian Healthcare SystemPublic Romanian Healthcare System
ClassificationClassification
Primary Health Care Units provide:
General medical and ambulatory services.
Outpatient clinics but without an operating theatre of specialized investigative labs.
Secondary Health Care Units provide:
Outpatient Medical Centres and Outpatient Specialized Clinics General or Specialized Hospitals . These hospitals have various departments and operating rooms for both basic and
specialized medical services. These specialties would include cardio surgery, neurosurgery, microsurgery, and oncology.
Both Primary Health Care Units and Secondary Health Care Units are located in the locality in either a city or a town
Tertiary Health Care Units are:
University Hospitals located in a major city or Regional Hospitals that are regional in scope (ie. they service one or more
of the 42 counties that make up Romania).
They include Institutes (eg. Contagious Disease Institute) and Hospitals that offer higher learning or a specialization.
Pro EAST Consulting 2011
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Private Romanian healthcare system classificationPrivate Romanian healthcare system classification
The Romanian Private Healthcare System is organized as follows:
Individual doctors ambulatories
Outpatient Medical Centres (diagnosis and treatment)
Outpatient Specialized Clinics (specialized medicine) Hospitals: both General and Specialized.
All the Private Medical Centres and Private Hospitals are locally based; that is, they do not service an entire
county.
None of the University Hospitals are Private.
None of the existing Private Hospitals specialize in Emergency Care.
None of the Local Hospitals are private
Pro EAST Consulting 2011
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Private Outpatient Medical CenterPrivate Outpatient Medical Center
Private Medical Centres first started to appear in 1995, primarily in the larger cities.The
majority functioned as local diagnostic and treatment centres.
Multidisciplinary Outpatient Medical Centres focus on diagnostic services and treatment. They are
equipped with laboratories and a radiology unit (Xray, CT, Ultrasound). Eventually their imaging
units will expand to include MRI.
Specialised Clinics. These medical clinics provide medical services of one speciality plus laboratories
and eventually imagistic unit.
The majority of the Specialized Clinics established during the past few years are specialized in the
following medical disciplines: Obstetrics, Gynaecology and Fertilisation, E.N.T (ORL),
Ophthalmology, Plastic Surgery, General Surgery, Orthopaedics, Oncology, Proctology, RadiologyImagistic, Phlebology, Rehabilitation , Stomatology. See slide 14
Pro EAST Consulting 2011
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DistributionDistribution
Private Outpatient Medical Centres and Specialized Clinics are distributed throughout Romania but are
concentrated in cities with populations over 150.000;
There is a high concentration of private Medical Centres and Specialized Clinics in the capital city ofBucharest. The number of multi-discipline Outpatient Medical Centres located in Bucharest (100) is
almoust equal to the number of such Centres located throughout the Rest of Romania (over 90).
The major players in the healthcare sector are currently the following companies:
Romar (18 centers),
Unirea Medical Center (16),
Medcenter ( 13 )
Hiperdia (12)
Medicover ( 11)
See slide 11
Pro EAST Consulting 2011
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11
Major private Outpatient Medical Centers in RomaniaMajor private Outpatient Medical Centers in Romania
Name of the medical center
Total no. of
centers in
Romania
No. of
centers in
Bucharest
No. of
centers in
other cities Cities ( Abbreviation*) Web adress
ROMAR 18 4 14
Ct, Is, Pl, Tm, Gl, Braila, Bz Branesti, Hd,
Roman, Tgv, Tg J, Gr* www.romar.ro
CENTRUL MEDICAL UNIREA 16 11 5 Cj, Ct, Pl, Tm*,Bc,Bv www.cmu.ro
MEDICOVER 11 4 7 Bv, Cj, Ct, Fcs, Is, Pl, Tm* www.medicover.ro
MEDCENTER 13 4 9 Bv, Cj, Fcs, Is, Gl, BM,Braila, Bz* www.medcenter.ro
HIPERDIA 12 4 8 Bv, Cj, Pl, Bistrita, SM, Turda, Tm, Gl* www.hiperdia.ro
GRAL MEDICAL 4 2 2 Pit, Sb www.gralmedical.roMEDICAL CITY 9 1 8 Pit, Cv, Ct, Turda, Tm, Arad, Bc, Bz* www.medicalcity.ro
MEDLIFE 10 7 3 Cluj, Timisoara,Bv www.medlife.ro
POLISANO CLINIQUE 6 3 3 Sibiu www.polisano.ro
CLINICA MEDICALA ROMGERMED 2 2 0 Bucuresti www.romgermed.ro
MEDAS 4 4 0 Bucuresti www.medas.ro
PARAMEDICAL CENTER 5 0 5 Cluj www.cmpro.ro
CENTRUL MEDICAL ELIM 4 0 4 Pitesti, Rm Vl,Curtea de Arges www.cmelim.ro
POLIMED 3 1 2 Azuga, Busteni www.polimed.ro
EUROCLINIC 3 3 0 Bucuresti www.euroclinic.ro
SANADOR 3 3 0 Bucuresti www.sanador.roMEDSANA 3 2 1 Ploiesti www.medsana.ro
CENTRUL MEDICAL CLINIMED 3 0 3 Alba Iulia www.clinimed.ro
CENTRUL MEDICAL GALAMED 2 0 2 Constanta www.galamed.ro
MEDICAL CENTER DIAGNOSIS 2 2 0 Bucuresti www.diagnosis.ro
MEDICAL CENTER PRO LIFE 2 2 0 Bucuresti www.pro-life.ro
BIOTERRA MED 2 2 0 Bucuresti www.bioterramed.ro
BIOMEDICA 2 2 0 Bucuresti www.bio-medica.ro
CENTRUL MEDICAL IOWEMED 2 0 2 Constanta www.iowemed.ro
CENTRUL MEDICAL ANIMA 3 2 1 Bucuresti, Pitesti www.anima.ro
11
Pro EAST Consulting 2011
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Major private Outpatient Medical Centers in RomaniaMajor private Outpatient Medical Centers in RomaniaContinued slide 11Continued slide 11
Pro EAST Consulting 2011
CENTRUL MEDICAL PLUS MEDICA 3 3 0 Bucuresti www.pulsmedica.ro
CENTRUL MEDICAL SOLOMED 2 0 2 Pitesti www.solomed.ro
CENTRUL MEDICAL BIOCLINICA 2 0 2 Arad, Timisoara www.bioclinica.ro
CENTRUL MEDICAL ACADEMICA 1 1 0 Bucuresti www.academica-medical.ro
ALSAMED 1 1 0 Bucuresti www.alsamed.ro
ANAIS MEDICAL CENTER 1 1 0 Bucuresti www.anais.ro
ENDOCENTER 1 1 0 Bucuresti www.endocenter.ro
EXCELLENCE MEDICAL CENTER 1 1 0 Bucuresti www.medicalexcellence.ro
MATEI BASARAB MEDICAL CENTER 1 1 0 Bucuresti www.cmmb.roMEDICLASS 1 1 0 Bucuresti www.mediclass.ro
SANYS MEDICAL 1 1 0 Bucuresti www.sanysmed.ro
CENTRUL MEDICAL VERONIKI 1 1 0 Bucuresti www.veronikilife.ro
CENTRUL MEDICAL VICTOR BABES 1 1 0 Bucuresti www.cdt-babes.ro
CENTRUL MEDICAL LUX-RO 1 0 1 Botosani www.lux-ro.ro
CENTRUL MEDICAL ARTRIMED 1 0 1 Cluj
CENTRUL MEDICAL MEDSTAR 2000 1 0 1 Constanta www.medstar2000.ro
CLINICA MACTA (MEDICAL ALALYSIS) 1 0 1 Constanta www.chirurgieunc.ro
CENTRUL MEDICAL MICROMEDICA 1 0 1 Neamt www.micromedica.ro
COMPLEX MEDICAL G&E&N 1 0 1 Oradea www.gen.ro
CENTRUL MEDICAL DR.LUCA 1 0 1 Pitesti,Rm.Vl
CENTRUL MEDICAL SANMED 1 0 1 Rm.Valcea www.sanmed.ro
POLICLINICA VISA MEDICA 1 0 1 Sibiu www.visamedica.ro
CENTRUL MEDICAL DELTA PRO
MEDICAL 1 0 1 Bucuresti www.deltapromedical.ro
CENTRUL MEDICAL MINERVA 1 0 1 Timisoara www.cmminerva.ro
CENTRUL MEDICAL IRINA (EXPERT
MED) 1 0 1 Galati www.expert-med.ro
12
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Major private Outpatient Medical Centers in RomaniaMajor private Outpatient Medical Centers in RomaniaContinued slide 12Continued slide 12
MARY MEDICAL CENTER 1 1 0 Bucuresti www.marymed.ro
CENTRUL MEDICAL ENDOCENTER 1 1 0 Bucuresti www.endocenter.ro
ALPHA HEALTH CENTER 1 1 0 Bucuresti www.alphamed.ro
MEDICAL CITY BLUE 1 1 0 Bucuresti www.medicalcity.ro
CENTRUL MEDICAL HIPOCRATE 1 0 1 Timisoara www.hipocrate.ro
Total: 175 81 94
13
Pro EAST Consulting 2011
Note:* Alba Iulia= Ab I,Galati= Gl, Bucuresti = Buc, Giurgiu= Gr, Baia Mare= Bc, Hunedoara= Hd, Botosani= Bots,
Iasi= Is, Brasov= Bv, Neamt= Nt, Braila= Br, Ploiesti= Pl, Buzau= Bz, Pitesti=Pit, Cluj= Cj, Sibiu=Sb,
Craiova=Cv , SatuMare=SM, Constanta= Ct, Tulcea=Tl, Focsani= Fcs, Targu Jiu= Tg J, Timisoara= Tm,
Note: Last update January 2011Source: internet, database
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Private Outpatient Specialized ClinicsPrivate Outpatient Specialized Clinicsin Bucharestin Bucharest
The most common medical specialities for private Outpatient Specialized Clinics (with or without surgical units) are listed below. The restriction of a
maximum 24 hours hospitalization is applicable to all.
Obstretics, Gynecology and Fertilisation 22
ENT (ORL ) 19
Ophthalmology (with surgery) 17
Labor medicine 12
Plastic and reparatory surgery 11
General surgery 9
Imagistic (CT, MRI; eventually PET-CT) 10 *
Orthopedic (without surgery) 8
Proctology 8
Rheumatology 5
Dermatology 4
Cardiology and interventional cardiology with day hospital 3
Radiology and interventional cardiology 2
Diabetic and nutrition diseases 2
Phlebology 2
Rehabilitation Therapy 2
Stomatology, Implantology - minimum 50
TOTAL NO. OF BRANCH MEDICAL CLINICS IN BUCHAREST 181
Note : * Are not included the imagistic departments from the Outpatient Medical Centers
Pro EAST Consulting 2011
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Private Hospitals in RomaniaPrivate Hospitals in Romania
Of the 24 private Hospitals currently operational in Romania, 14 are General Hospitals and
10 are Specialized Hospitals.
7 out of 10 private Specialized Hospitals are specialize in obstetrical & gynaecology
None of the private hospitals specialize in other high demand, high priority medical
disciplines such as:
oncology and surgical oncology
emergency room /emergency surgery
Just one specialized hospital is specialized in cardiology surgery.
Since 2008, several health care companies have announced their intention to construct new
private hospitals. There are plans to build 15 new private Hospitals 14 in Bucharest by the
year 2013. This new construction would increase existing bed capacity in Bucharest from 281
beds to over 1286 beds . This represents an estimated investment value of minimum 300
million Euros.(see slide 19).
Pro EAST Consulting 2011
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Private hospitals in Romania
Pro EAST Consulting 2011
17
Crt.
No. Hospital name
Hospital type No.
of
beds
City/Area of
Romania
Shareholders
Nationali ty Affil iation or Member of a Group/Chain
1 Life Memorial Hospital General 127
Bucharest-
South
IFC, Cristescu Mihaela Gabriela, Nicolae
Marcu, Mihail Marcu, SGAM Eastern
Europe (Societe General)
Great Britain/France/
Romania Medlife
2 Euroclinic Hospital General 100
Bucharest-
South CMU / Eureko Group
Germany/
Holland CMU / Eureko Group
3
CMU ,,Arcul de Triumf
Hospital
General
9
Bucharest-
South
Advent International Investment
Found(80%) ,Mr. Enayati Germany
CMU = Unirea Medical Center
4 Munposan Hospital Branch (Surgery) 35
Bucharest-
South
Becico Victoria, Munteanu Codrut,
Sangiorzan Anton Romania No
5 Genesys Hospital General 45 Arad-West
Guset Grigorie, Jivan Adrian, Miclea
Iulius, Paiusan Lucian Romania Accipiens
6 Laser System Hospital General 11 Arad-West UNK Romania Laser System Medical Center SRL
7 Palade Hospital General 22
Bacau-North-
East UNK Romania Palade Hospital Ltd
8 Clinicco Hospital
Branch (Surgery of
Cardiology and Orthopedic
prosthesis) 35 Brasov-Center UNK Romania No
9 Pelican Hospital General 80
Oradea-North-
West
Adrian Maghiar, Doru Maghiar si
Ovidiu Cacuci Romania No
10 Arcadia Hospital General 220 Iasi-East Fiterman UNK No
11 Polisano Hospital General 50 Sibiu-Center Vonica Ilie, Vonica Daniela Romania Polisano
12 Bethesda Hospital General 48
Suceava-
North-East UNK No
13 Nova Vita Hospital General 126
Targu Mures-
Center Virgil Mailat Romania No
14 Brol Hospital General 41
Timisoara-
West
Marinescu Eva, Bratu Ioan, Bratu
Tatiana Romania No
15 Athena Hospital General 118
Timisoara-
West Konstantions Giatras Greece No
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Private hospitals in RomaniaContinued slide 17Continued slide 17
Pro EAST Consulting 2011
18
Crt.
No. Hospital name
Hospital type No.
of beds
City/Area of
Romania
Shareholders
Nationality
Affiliation or Member of
a Group/Chain
16 Dr. Irimia Hospital Surgery hospital 16 Pitesti
Fam. Dr. Irimia and
Romano-israelian
Invsestment Found Romania
17 Euromedica Hospital General 40
Baia Mare-
North West
Mociran Mihaela,
Chertif Costache
Mociran Mihaela
Pop Calin FlorinPop Coriolan
Sasaran Mircea Romania Euromedica Hospital S.A.
18 Eva Clinic Branch (Obstetric-gynacology) 35 Brasov-Center UNK UNK
19 Sanovil Clinic Branch (Obstetric-gynacology) 30
Bistrita _
North-West UNK UNK Sanovil Clinic S.R.L.
20 Isis Medical Center Branch (Obstetric-gynacology) UNK
Constanta
South-East UNK UNK Isis Medical Center S.R.L.
21 Gynia Hospital Branch (Obstetric-gynacology) 34
Cluj
North-West UNK UNK Gynia S.R.L.
22 Hipocrate Hospital Branch (Obstetric-gynacology) 7
Cluj
North-West UNK UNK Hipocrate Impex S.R.L.
23
CMU Regina Maria
Hospital Branch (Obstetric-gynacology) 25 Bucharest South
Advent International
Investment Found(80%)
,Mr. Enayati Germany
CMU = Unirea Medical
Center
24 Euromaterna Hospital Branch (Obstetric-gynacology) 20
Constanta
South East
Ion Marius Rusa, Ion
Sebastian Lutescu, Ioana
Lutescu, Florian Dantes,
Dan Mugurel Raica, Rucni
Asan, Rafael Ron-El. Romania Euromaterna S.A.
Total 1284
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Private HospitalPrivate Hospital New Projects to 2013New Projects to 2013
Pro EAST Consulting 2011
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Source: articles from online press , internet.We present just the public announced projects.Note: UNK - unknown date
* Medlife investments subtotals also include the Medlife Hospital from Brasov
Company name Hospital type Invest
ment
mil.eu
No.of
beds
Hospital
surface
sqm
Localization Time limit Shareholders Nationality
Medlife Genera l UNK 120 10,000 Buchares t 2011 IFC , Cris tes cu M., Nicolae M., Mihail M., SGAM Eas ten United Kingdom, France / Romania
Medlife &Dermastyle Dermatology & estetical
surgery
3 UNK 1,500 Bucharest 2011 IFC, Cristescu M., Nicolae M., Mihail M., SGAM Easten
Europe
United Kingdom, France / Romania
Medlife Special ized (urology) UNK UNK 3,800 Bucharest 2011 IFC, Cristescu M., Nicolae M., Mihail M., SGAM Easten United Kingdom, France / Romania
Medlife Special ized (pediatrics) UNK UNK 5,200 Bucharest 2011 IFC, Cristescu M., Nicolae M., Mihail M., SGAM Easten United Kingdom, France / Romania
Medlife investments
subtotals 2011-2013 *
45
CMU Specialized (surgery) 10 UNK UNK Bucharest 2011 80% Advent International, Enayati, 3Pi Germany/Romania
CMU General 25 UNK UNK Bucharest 2011-2012 80% Advent International, Enayati, 3Pi Germany/Romania
Gral Medical General (cardioloy, 25 100 9,000 B ucharest 2012 Dr.Gerogeta & D r.Robert Stefan Romania
Medicover General 50 200 12,900 Bucharest 2013 ABC Medicover Holding Sweden
Medicover General 10 75 UNK Bucharest 2011 ABC Medicover Holding Sweden
Medsana General 24 150 UNK Bucharest 2011 Athens Medical Center Greece /Germany
Romar Medical General 25 UNK UNK Bucharest 2012 Dr.Erghin Hagicalil, Dr.Liliana Hagicalil Romania
Medicana General (cardioloy,
oncology, in vitro
fertilization)
30 100 10,000 Bucharest UNK Medicana Group Turkey
Sanador General 50 135 14,000 Bucharest 2011 Dr.Doris Andronescu Romania
Delta Pro Specialized (surgery) UNK 50 2,500 Bucharest Feb-11 Dr.Copaescu, Dr.Jianu Romania
Total Bucharest 294 930
Medlife General UNK 75 6,000 Brasov 2011 IFC, Cristescu M., Nicolae M., Mihail M., SGAM Easten
Europe
United Kingdom, France / Romania
Total Investment
hospitals in other
cities UNK 75
Total general 294 1005
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Synoptic table private hospitals in RomaniaSynoptic table private hospitals in Romania
and Bucharestand Bucharest
Pro EAST Consulting 2011
20
2011
2011-2013
(new
projects)
2011-2013 ( existing private
hospitals+future projects)
Romania
No. of hospitals 24 15 39
No. of beds* 1284 1005 2289
Bucharest Out of which Out of which Out of which
No. of hospitals 5 14 19
No. of beds* 281 1005 1286
Note: *Not all the future hospitals have reported the number of beds
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Private hospital locationPrivate hospital location --
existing and new projects untill 2013existing and new projects untill 2013
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The Major Private Healthcare CompaniesThe Major Private Healthcare CompaniesThe private medical services market estimatedThe private medical services market estimated
at 430 mil euroat 430 mil euro in 2009in 2009
Pro EAST Consulting 2011
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Source:Oficiul National al regsitrului Comertului
Note: * Advent International Investment Fund bought in February 2010 80% from CMU stocks
Largest private healthcare companies owners of hospitals and outpatient medical centers
No.
crt.
Company/Web address Turnover 2009 (mil.
) Employees
General manager/Phone
Shareholders2009 2008 2009 2008
1
MED LIFE
www.medlife.ro 26 21,2 990 844 Mihail Marcu 021/2226415
IFC, Cristescu Mihaela Gabriela, Nicolae
Marcu, Mihail Marcu, SGAM Eastern
Europe (Societe General)
2 CENTRUL MEDICAL UNIREA www.cmu.ro 13,7 10,9 700 350 Wargha Enayati 021/2229294 Enayati family, Advent International
3MEDICOVERwww.medicover.ro 11.6 12,8 NA 428 Marina Otelea 021/3191699 ABC Medicover Holding (Sw)
4
GRAL MEDICAL
www.gralmedical.ro 10.7 10 430 371 Robert Serban 021/3230004 Robert and Georgeta Serban
5
HIPERDIA
www.hiperdia.ro 10 9,3 224 251 Tiberiu Roth 0268/473608 Southeast Europe Equity Fund
6
SANADOR
www.cmsanador.ro 9,7 9,4 450 400 Doris Andronescu 021/3230260 Doris Andronescu
7
CENTRUL MEDICAL ROMAR
www.romar.ro 9 10,6 503 447Liliana Hagicalil 021/3310301 Else Comp. Ltd., RC2
8 CLINICA POLISANO www.clinicapolisano.ro 8,8 4,9 262 160 Dan Rosca 0269/234486 Ilie si Daniela Vonica
9
EUROCLINIC
www.spitaluleuroclinic.ro 8 6,6 341 258 Catalin Popa 021/2006800 Eureko
10
MEDCENTER
www.medcenter.ro 7,2 10 470 510 Florin Balanica 021/2424477 Medicarom
11
MEDSANA BUCHAREST MEDICAL
CENTER www.medsana.ro 5,9 6,2 373 373 Vassilis Chaniotis 021/4087800
Athens Medical Group of Companies
(Greece)
12 EUROMEDIC ROMANIA www.euromedic.ro 5,4 NA 549 414 Anca Petca 021/2224111
Ares Life Sciences, Merrill Lynch Global
private Equity
13
CENTRUL MEDICAL MED-AS 2003
www.medas.ro 4,5 NA NA NA Simona Ateia 021/3102138 Simona Ateia
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Public and Private Insurance System
The NATIONAL HEALTH INSURANCE HOUSE (hereafter called NHIH) is the national health insurance plan
for the country. All citizens insured under the NHIH plan are entitled to healthcare services at any public
institution (ie medical centre or hospital)
All private Hospitals are entitled to sign agreements with the National Health Insurance House which afford
partial reimbursement of medical costs for diagnostic and treatment services provided to patients covered
under NHIH.
The contract regarding the conditions applicable to the NHIH plan including coverage and levels of
compensation is reviewed by the Romanian Government. It can be said that patients covered under the
NHIH plan but treated at a Private Hospital are generally entitled to partial reimbursement of the costs of
their diagnostic and treatment services.
For the year 2011, the average reimbursement provided for under the NHIH for surgery is 350 euros. The
specific amount reimbursed to a Private Hospital for a surgical procedure is governed by the contract
negotiated between the specific Hospital and the NHIH. Such contracts are negotiated annually.
The private healthcare insurance system in Romania is still at the start-up stage. Even though there are anumber of renowned Insurance Companies competing in the Romanian Market (eg. Generali Group, Allianz,
BCR, AIG, BCR, ING Insurance and Adorama), the Healthcare Insurance products on offer are very basic
such as medical check-up insurance. The absence of a more robust and substantial Healthcare Insurance
program is considered the main reason why there are currently only 24 private hospitals for a population
of over 21 million.
Pro EAST Consulting 2011
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Public and Private Insurance System
We predict that the Private Healthcare Insurance market will expand and become far more developed
starting in the year 2012 when another 15 Private Hospitals will become operational (see slide 19).
It is noted that all announced new hospital construction projects are located in Bucharest. This will result in
disproportionate regional levels of service.
Country Wide - 39 private hospitals in Romania population 21 million ( 1 hospital for 538.461 inhabitants)
In Bucharest - 19 private hospitals estimated population 3 million (1 hospital for 157.894 inhabitants)
Rest of Romania - 20 private hospitals - population 18 million ( 1 hospital for 900.000 inhabitants)
Even though the ratio of hospitals to number of inhabitants is very low compared to other parts of Europe, the new private
hospitals will in fact offer medical services in speciality areas that are seriously under represented today and for which
services are severally lacking. These new hospitals will provide medical services in the high priority areas of cardiology,oncology and major surgery.
Pro EAST Consulting 2011
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Sources of RevenueSources of Revenue
The main sources of revenues for the Private Healthcare System are:
Patients paying directly to the hospital
Patients with Corporate medical coverage (often included as part of the compensation
package offered to employees of multinational companies). Corporate coverage may be
valid for one service provider (as chosen by the employer) or for any Private Medical
Centre up to a certain financial limit.
Patients with Individual Healthcare Insurance. Both types of healthcare subscriptions are
valid only in an clinics network. (example: Unirea Medical Center subscription can be used just inthe company network clinics and hospitals)
The partial reimbursement offered under the National Health Insurance House , (eg 350euros per surgical procedure.)
Private insurances (limited services)
Pro EAST Consulting 2011
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ObservationsObservations
The actual growth enjoyed by 10 of the 13 major private healthcare companies in Romania falls within this
range (see slide 21).
Some of the companies that opened Outpatient Medical Centers and Specialized Clinics in Bucharest and
elsewhere in Romania now plan to expand and construct General or Specialized Hospitals.
In present they are only five companies
that have to date opened
private General Hospitals
with more than 100 beds:
Fiterman 220 beds, from IasiLife Memorial Hospital 127 beds, from Bucuresti
Nova Vita San 126 beds, from Targu Mures
Athena 118 beds, from Timisoara
Euroclinic (CMU) 100 beds from Bucuresti
Pro EAST Consulting 2011
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ObservationsObservations
The public healthcare system is developed throughout Romania and includes all the medical
centers and hospitals categories (slide 5). The hospitals units are generally located in old
buildings and the medical equipment is inadequate in many hospitals. The medical staff has
high level qualification. The same professors and doctors are working also in the private
system .
The medical fee structures applied by the various private hospitThe medical fee structures applied by the various private hospitals in Bucharest are essentiallyals in Bucharest are essentially
identical. The differences are not significant (slide 26).identical. The differences are not significant (slide 26).
Pro EAST Consulting 2011
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Conclusions
The varioius legislation governing the delivery of healthcare services is relatively new and has been drafted
to respect UE standards.
The Romanian Public Healthcare Sector is under financed. The Government allocation of just 5% of GDP is
grossly insufficient.
The Private Healthcare sector is under developed. To meet current and future market demands, the privatesectors further development must be accelerated.
The Private Healthcare sector is much more developed in Bucharest than the rest of Romania. This may lead
to disproportionate levels of service throughout the country with rural areas being disadvantaged. Given
the high concentration of start ups planned for Bucharest in the coming two years, this disportionate access
to private medical services is likely to occur sooner than later..
There is currently a substantial void of Specialized Clinics or Specialized Hospitals in high priority
specialties such as; general surgery, cardiology,oncology and oncology surgery, emergency services. After
2012, there will be a number of Specialized Hospitals that will focus on one or more of these priority
services.
Pro EAST Consulting 2011
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Conclusions
The private hospitals are not connected to the 112 emergency number (911 in USA). None of the Private
hospitals are specialized in Emergency Care.
We estimate that the private insurance system will be more developed and diversified starting with 2012
The healthcare private market is maintaining its growth trend 35% in 2009 and 20% in 2010
7 out of top ten healthcare companies had a grow in turnover in 2009 compared with 2008
The main sources of revenues for the private medical units are patients paying directly and subscription to
a medical chain units
Pro EAST Consulting 2011
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APPENDIXES
Pro EAST Consulting 2011
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Appendix no.1
List of hospital regulations
The healthcare system in Romania is governed also by:
In addition, the construction and operation of hospitals in Romania are governed by the Ministry of Health
(Order OSMP 914/2006 last updated by1030/2009) which contains 47 pages of very specific rules
regarding internal structure, location and environmental impact.
The design and construction of hospital buildings and installations must be compliant with Regulation NP-015-97; the anesthesiology and intensive care units with regulation 1500/24 and the Emergency Unit with
regulation 1706/2 dated October 2007.
1500/24 November 2009 (regarding the organization and the functioning of the units and the anesthesia
and intensive care departments in hospitals),
1706/2 October 2007 ( regarding the management and the organization of the units and the emergency
room).
Pro EAST Consulting 2011
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Appendix no 2Appendix no 2
List of Major Pharmaceutical Companies (2009)List of Major Pharmaceutical Companies (2009)
Pro EAST Consulting 2011
33 Turnover( mil . )
2009 2009% 2008%
1 Sanofi- Aventis/ Zentiva 194,2 10,1 10,7 *
2 Hoffmann La Roche 174,2 9,0 7,3
Pfizer/ Wyeth , , ,
4 GlaxoSmithKline 122, ,4 ,9
5 Novartis 114,0 5,9 6,6
Servier , ,
7 Merck/ Schering Plough 85,2 4,4 3,7 ***
8Ranbaxy
, , ,
9 Astrazeneca 63,3 3,3 2,5
10 Abbott/ Solvay 52,1 2,7 N/A
11 Antibiotice Iasi 49,0 2,5 2,7
Bayer , , ,
Eli Lilly , , ,
14 Menarini 40,4 2,1 2,1
15 Labormed / Ozone 40,0 2,1 New entry
KRKA , , ,
17 Activis 34,3 1,8 1,7
18 Johnosn & Johnson 30,9 1,6 1,6
19 Gedeon Richtel 27, 1,4 1,5
20 Reckitt Benckiser 27,2 1,4 New entry
Total 1. 493,50 77,4
S ur sa : R ap or t ceg eg im pr el ua t d e Zi ar ul fi na nci ar 7 ma i 2 01 0 No ta : Ceg ed im a f ur ni za r va nz ari le i n l ei si au fo st tra ns fo rm at e d e ZF la un cu rs de 4,2 lei pt . u n
* Co ta d e p ia ta cu mul at a a co mpa ni il or S ano fi - A vent is si Zen ti va ; D at el e s un t l a p ret ur i P PP , a di ca la i es ir ea di n f ar maci i.
**Cota de piata doar pentru compania Pfizer
*** cota cumulata pentru Merck si Schering Plough. Aceste cote au fost calculate cumulat de ZF
Market shareCompany/Group/ Web adressPosition
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APPENDIX no 3APPENDIX no 3
High Risk Diseases in RomaniaHigh Risk Diseases in Romania
Between July 2007 - June 2008, the Ministry of Health completed an evaluation of the state
of public health. (Riscograma 2008 )
A total of 11,104,655 persons were evaluated; 57,6% women and 43,4% men.
The risk evaluation identified a total of 4,114,969 persons at risk of being further inflicted
with a disease (37% of the group surveyed).
30% of the group or 3.323.156 persons were found to be at risk of developing mellitius
diabetes 7% of the group or 805.989 persons were found to be at risk of developing cardiovascular
diseases
6% of the group or 671.696 persons presented chances of developing oncologycal
diseases (cancer).
Pro EAST Consulting 2011
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