of 33
8/8/2019 Pro East - Private Healthcare System
1/33
THE PRIVATE HEALTHCARE SYSTEM
IN ROMANIA
General Information
November 2010, Bucharest
8/8/2019 Pro East - Private Healthcare System
2/33
Content
Introduction. 3
Terminology . 4
Legal framework 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... 13
Private hospitals in Romania................................... 14
Synoptic table private hospitals in Romania and Bucharest 19
Private hospital location by map20
The major private healthcare companies 2009...21
Public and private insurance system.22
Sources of revenue24
Comparative prices for available medical services in private hospitals in Bucharest25
Observations.26
Conclusions..28
Apendix
List of hospital regulations
The most frequent chances of developing diseases in Romania
The major pharmaceutical companies in 2009 Pro EAST Consulting 2010
2
8/8/2019 Pro East - Private Healthcare System
3/33
Introduction
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 and affiliation with any medical
companies. New hospital construction projects are classified according to; amount of investment; number of
beds; location; expected launch date and the names and nationalities of the shareholders.
Pro EAST Consulting 2010
3
8/8/2019 Pro East - Private Healthcare System
4/33
Therminology
The various private medical units in operation today can be defined as follows:.
Outpatient Medical Centres (for diagnosis and treatment): are policlinics that 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 willeventually 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.
Pro EAST Consulting 2010
4
8/8/2019 Pro East - Private Healthcare System
5/33
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 detailed
information.
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 2010
8/8/2019 Pro East - Private Healthcare System
6/33
Medical Services Market
The Government of Romania currently allocates 4,7 % 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 2010
6
0
100
200
300
400
500
600
2008 2009 2010
Estimated privatemedical services in Romania
Value in millions Euro
8/8/2019 Pro East - Private Healthcare System
7/33
Public Romanian Healthcare System
Classification
Primary Health Care Units provide:
General medical and ambulatory services.
General diagnostic services including laboratory analysis of blood and fluid
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 2010
7
8/8/2019 Pro East - Private Healthcare System
8/33
Private 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.
Pro EAST Consulting 2010
8
8/8/2019 Pro East - Private Healthcare System
9/33
Private 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 imagingunits 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, Radiology Imagistic, Phlebology, Rehabilitation , Stomatology. See slide 13
Pro EAST Consulting 2010
9
8/8/2019 Pro East - Private Healthcare System
10/33
Distribution
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 of
Bucharest. The number of multi-discipline Outpatient Medical Centres located in Bucharest (100) is
equal to the number of such Centres located throughout the Rest of Romania (97).
The major players in the healthcare sector are currently the following companies:
Romar (18 centers),
Unirea Medical Center (12 ),
Medicover ( 12) Medcenter ( 12 )
See slide 11
Pro EAST Consulting 2010
10
8/8/2019 Pro East - Private Healthcare System
11/33
11
Major private Outpatient Medical Centers in Romania
Name of the medical center Total no. ofcenters in
Romania
No. ofcenters in
Bucharest
No. ofcenters 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* www.cmu.ro
MEDICOVER 12 5 7 Bv, Cj, Ct, Fcs, Is, Pl, Tm* www.medicover.ro
MEDCENTER 12 4 8 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 9 5 4 Pit, Sb, Cv, Pl* www.gralmedical.ro
MEDICAL CITY 9 1 8 Pit, Cv, Ct, Turda, Tm, Arad, Bc, Bz* www.medicalcity.ro
MEDLIFE 9 7 2 Cluj, Timisoara www.medlife.ro
POLISANO CLINIQUE 6 3 3 Sibiu www.polisano.ro
CLINICA MEDICALA ROMGERMED 5 5 0 Bucuresti www.romgermed.ro
MEDAS 5 3 2 Pitesti, Giurgiu www.medas.ro
PARAMEDICAL CENTER 5 0 5 Cluj www.cmpro.ro
CENTRUL MEDICAL ELIM 4 0 4 Pitesti www.elim.ro
POLIMED 4 2 2 Targoviste 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 3 0 3 Constanta www.sfatulmedicului.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.biomedica.ro
CENTRUL MEDICAL IOWEMED 2 0 2 Constanta www.iowemed.ro
CENTRUL MEDICAL IRINA (EXPERTMED) 2 0 2 Galati, Braila www.expert-med.ro
11
Pro EAST Consulting 2010
http://www.cmpro.ro/http://www.elim.ro/http://www.polimed.ro/http://www.clinimed.ro/http://www.sfatulmedicului.ro/http://www.iowemed.ro/http://www.expert-med.ro/http://www.expert-med.ro/http://www.expert-med.ro/http://www.expert-med.ro/http://www.iowemed.ro/http://www.sfatulmedicului.ro/http://www.clinimed.ro/http://www.polimed.ro/http://www.elim.ro/http://www.cmpro.ro/8/8/2019 Pro East - Private Healthcare System
12/33
1212
Major private Outpatient Medical Centers in RomaniaContinued slide 11
Pro EAST Consulting 2010
CENTRUL MEDICAL SOLOMED 2 0 2 Pitesti www.solomed.ro
CENTRUL MEDICAL BIOCLINICA 2 0 2 Arad, Timisoara
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.ro
MEDICLASS 1 1 0 Bucuresti www.mediclass.ro
SANYS MEDICAL 1 1 0 Bucuresti www.sanysmed.ro
CENTRUL MEDICAL VICTOR BABES 1 1 0 Bucuresti www.cdt-babes.ro
CCENTRUL 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
CENTRUL MEDICAL STRAUBING 1 0 1 Rm.Valcea www.straubing.roPOLICLINICA VISA MEDICA 1 0 1 Sibiu www.visamedica.ro
CENTRUL MEDICAL MINERVA 1 0 1 Timisoara www.cmminerva.ro
Total: 176 79 97
12
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 October 2010Source: internet, database
http://www.solomed.ro/http://www.academica-medical.ro/http://www.cdt-babes.ro/http://www.lux-ro.ro/http://www.medstar2000.ro/http://www.chirurgieunc.ro/http://www.micromedica.ro/http://www.gen.ro/http://www.straubing.ro/http://www.visamedica.ro/http://www.cmminerva.ro/http://www.cmminerva.ro/http://www.visamedica.ro/http://www.straubing.ro/http://www.gen.ro/http://www.micromedica.ro/http://www.chirurgieunc.ro/http://www.medstar2000.ro/http://www.lux-ro.ro/http://www.lux-ro.ro/http://www.lux-ro.ro/http://www.cdt-babes.ro/http://www.cdt-babes.ro/http://www.cdt-babes.ro/http://www.academica-medical.ro/http://www.academica-medical.ro/http://www.academica-medical.ro/http://www.solomed.ro/8/8/2019 Pro East - Private Healthcare System
13/33
Private Outpatient Specialized Clinicsin 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) 16
Labor medicine 12
Plastic and reparatory surgery 11 General surgery 9
Imagistic (CT, MRI; eventually PET-CT) 9
Orthopedic (without surgery) 8
Proctology 8
Rheumatology 5
Dermatology 4
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 178
Pro EAST Consulting 2010
13
8/8/2019 Pro East - Private Healthcare System
14/33
Private Hospitals in Romania
Private hospitals arrived on the scene in 200510 years after the first private Outpatient
Medical Centre opened in Romania.
The main reasons for this extraordinary delay are:
- the long term investment required to undertake such a project and
- the absence of a robust private heath insurance system. The system that currently exists
requires further development and diversification.
There are currently only 23 private Hospitals in Romania ( including the maternities and
obstetrical and gynecology hospitals) with a total capacity of 1194 beds. This capacity is
very little compared to the current demand for medical services. Many patients with the
financial means go abroad or elsewhere in the European Union for medical treatment.
5 of the existing 23 private Hospitals are located in Bucharest (estimated population 3,5mil.).
The rest are located in cities with a population between 150 000 - 350 000.
While located in a specific city, their area of service is the entire surrounding region (see slide
20)
Pro EAST Consulting 2010
14
8/8/2019 Pro East - Private Healthcare System
15/33
Private Hospitals in Romania
Of the 23 private Hospitals currently operational in Romania, 14 are General Hospitals and 9
are Specialized Hospitals.
7 out of 9 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 12 new private Hospitalsall in Bucharest
by the year 2013. This new construction would increase existing bed capacity from 281beds to 1276 beds . This represents an estimated investment value of 317 million Euros
(slide 18).
Pro EAST Consulting 2010
15
8/8/2019 Pro East - Private Healthcare System
16/33
Private hospitals in Romania
Pro EAST Consulting 2010
16
Crt.
No. Hospital name
Hospital type No.
of
beds
City/Area of
Romania
Shareholders
Nationality Affi liation or Member of a Group/Chain
1 Life Memorial Hospital General 112
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 80Oradea-North-
WestAdrian Maghiar, Doru Maghiar si
Ovidiu Cacuci Romania No
10 Arcadia Hospital General 220 Iasi-East Fiterman 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 40
Timisoara-
West
Marinescu Eva, BratuIoan, Bratu
Tatiana Romania No
15 Athena Hospital General 70Timisoara-
West Konstantions Giatras Greece No
8/8/2019 Pro East - Private Healthcare System
17/33
Private hospitals in RomaniaContinued slide 16
Pro EAST Consulting 2010
17
Crt.
No. Hospital name
Hospital type No.
of beds
City/Area of
Romania
Shareholders
Nationality
Affiliation or Member of
a Group/Chain
16 Euromedica Hospital General 40
Baia Mare-
North West
Mociran Mihaela,
Chertif Costache
Mociran Mihaela
Pop Calin Florin
Pop Coriolan
Sasaran Mircea Romania Euromedica Hospital S.A.
17 Eva Clinic Branch (Obstetric-gynacology) 35 Brasov-Center UNK UNK
18 Sanovil Clinic Branch (Obstetric-gynacology) 30Bistrita _
North-West UNK UNK Sanovil Clinic S.R.L.
19 Isis Medical Center Branch (Obstetric-gynacology) UNK
Constanta
South-East UNK UNK Isis Medical Center S.R.L.
20 Gynia Hospital Branch (Obstetric-gynacology) 34
Cluj
North-West UNK UNK Gynia S.R.L.
21 Hipocrate Hospital Branch (Obstetric-gynacology) 7
Cluj
North-West UNK UNK Hipocrate Impex S.R.L.
22
CMU Regina Maria
Hospital Branch (Obstetric-gynacology) 25 Bucharest South
Advent International
Investment Found(80%)
,Mr. Enayati Germany
CMU = Unirea Medical
Center
23 Euromaterna Hospital Branch (Obstetric-gynacology) 20
Constanta
South East
Ion Marius Rusa, IonSebastian Lutescu, Ioana
Lutescu, Florian Dantes,
Dan Mugurel Raica, Rucni
Asan, Rafael Ron-El. Romania Euromaterna S.A.
Total 1194
8/8/2019 Pro East - Private Healthcare System
18/33
8/8/2019 Pro East - Private Healthcare System
19/33
Synoptic table private hospitals in Romania
and Bucharest
Pro EAST Consulting 2010
19
2010
2010-2013
(new
projects)
2010-2013 ( existing private
hospitals+future projects)
Romania
No. of hospitals 23 12 35
No. of beds* 1194 995 2189
Bucharest Out of which Out of which Out of which
No. of hospitals 5 12 17
No. of beds* 281 995 1276
Note: *Not all the future hospitals have reported the number of beds
8/8/2019 Pro East - Private Healthcare System
20/33
Private hospital location -
existing and new projects untill 2013
Pro EAST Consulting
20
8/8/2019 Pro East - Private Healthcare System
21/33
The Major Private Healthcare CompaniesThe private medical services market estimated
at 430 mil euro in 2009
Pro EAST Consulting 2010
21
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
3
MEDICOVER
www.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
8/8/2019 Pro East - Private Healthcare System
22/33
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 planincluding coverage and levels ofcompensationis 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 2010, 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 Health 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 23 private hospitals for a
population of over 20 million.
Pro EAST Consulting 2010
22
8/8/2019 Pro East - Private Healthcare System
23/33
Public and Private Insurance System
We predict that the Private Healthcare Insurance market will expand and become far more developed
starting in the year 2010 when another 12 Private Hospitals will become operational (see slide 18).
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 - 27 private hospitals in Romaniapopulation 20 million ( 1 hospital for 740.740 inhabitants)
In Bucharest - 16 private hospitalsestimated population 3,5 million (1 hospital for 218.750 inhabitants)
Rest of Romania - 11 private hospitals - population 16 ,5 million ( 1 hospital for 500.000 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 2010
23
8/8/2019 Pro East - Private Healthcare System
24/33
Sources 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 MedicalCentre 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 2010
24
8/8/2019 Pro East - Private Healthcare System
25/33
25
Fee Schedules for Private Hospitals located in Bucharest.
Pro EAST Consulting 2010
25
MEMORIAL LIFE
HOSPITAL (General
Hospital)
EUROCLINIC
General Hospital
REGINA MARIA
Gynecology
HOSPITAL( UMC)
MUNPOSAN
Surgery Hospital
Hospitalization fee/day 78 EUR double
149 EUR single
79-121 EUR (regular)
212 EUR VIP
100 EUR 40-110 EUR
Specialist visit 25 EUR 22 EUR 25 EUR 22 EUR
Professor visit 55 EUR 33 EUR 30 EUR 55 EUR
Radiologymammography 44 EUR 62- 80 EUR 20-34 EUR 10- 17 EUR
CT abdominal 68-120 EUR 117 EUR 61- 120 EUR
Abdominal ultrasound 39 EUR 50 EUR 42 EUR 22 EUR
Apendicectomy 620 EUR (without
hospitalization fee)
1707 EUR (included
hospitalization fee)
1000-1200 EUR 500 EUR (without
hospitalization fee)
Laparoscopic cholecistectomy 1098 EUR (without
hospitalization fee)
1527 EUR (included
hospitalization fee)
1200-1600 EUR 700 EUR (without
hospitalization)
Physiological birth 1902 EUR (without
hospitalization fee)
1707-1829 EUR
(included
hospitalization fee)
1516 EUR
Cesarean birth 1342 EUR (without
hospitalization fee)
2376 EUR (included
hospitalization fee)
1760 EUR
Mammoplasty 976-1951 EUR (without
hospitalization fee)
2583 EUR (included
hospitalization fee)
3000-4000 EUR
8/8/2019 Pro East - Private Healthcare System
26/33
Observations
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.
Medlife, Eureko, Nova Vita San and Fiterman are the four companies that have to date opened private
General Hospitals with more than 100 beds. They are located in Bucharest (2), Targu Mures and Timisoara(see slide 14).
Pro EAST Consulting 2010
26
8/8/2019 Pro East - Private Healthcare System
27/33
Observations
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 hospitals in Bucharest are essentially
identical. The differences are not significant. The single exception is Munposan Hospitala
small surgical Hospital that caters to patients from the Middle East.
Pro EAST Consulting 2010
27
8/8/2019 Pro East - Private Healthcare System
28/33
8/8/2019 Pro East - Private Healthcare System
29/33
8/8/2019 Pro East - Private Healthcare System
30/33
APPENDIXES
Pro EAST Consulting 2010
30
8/8/2019 Pro East - Private Healthcare System
31/33
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 withregulation 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 2010
31
8/8/2019 Pro East - Private Healthcare System
32/33
Appendix no 2
List of Major Pharmaceutical Companies (2009)
Pro EAST Consulting 2010
32Turnover( mil. )
2009 2009% 2008%
1 Sanofi- Aven tis/ Zentiva 194,2 10,1 10,7 *
2 Hoffmann La Roche 174,2 9,0 7,33 Pfizer/ W eth 126,6 6,6 5,2 **
4 GlaxoSmithKline 122,6 6,4 6,9
5 Novartis 114,0 5,9 6,66 Servier 105,3 5,5 6
7 Merck/ Scherin g Plough 85,2 4,4 3,7 ***
8 Ranbax 76,5 4,0 4,6
9 Astrazeneca 63,3 3,3 2,510 Abbott/ Solva 52,1 2,7 N/A
11 Antibiotice Iasi 49,0 2,5 2,7
Ba er , , ,13 Eli Lill 44,6 2,3 2,2
14 Menarini 40,4 2,1 2,1
15 Labormed / Ozone 40,0 2,1 New entry16 KRKA 36,3 1,9 2,3
17 Activis 34,3 1,8 1,7
18 Johnosn & Johnson 30,9 1,6 1,6
19 Gedeon Richtel 27,6 1,4 1,5
20 Reckitt Benckiser 27,2 1,4 New entryTotal 1. 493,50 77,4
S urs a: Ra po rt ceg eg im prel uat de Zia ru l f in an ci ar 7 m ai 20 10 Not a: Ceg ed im a f urn iza r van za ri le in lei si au fo st tr an sf orm at e d e ZF l a u n cu rs de 4 ,2 lei pt . u
* Co ta d e p ia ta cu mu lat a a co mp an ii lor S an of i - A ven ti s si Zen ti va ; D at el e su nt l a p ret uri PPP , ad ica l a i es irea d in f arm aci i.
**Cota de piata doar pentru compania Pfizer
*** cota cumula ta pentru Merck si Schering Plough. Aceste cote au fost calculate cumulat de Z
Market s hareCompany/Group/ Web adressPosition
8/8/2019 Pro East - Private Healthcare System
33/33
APPENDIX no 3
High 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).
33