Health Care

The Polish pharmaceutical sector at crossroads

HEALTH The Polish medicines policy is expected to undergo revolutionary changes in the coming months

- From the point of view of medicine producers, the dilemmas and challenges, which are faced by the Polish Minister of Health, are enormous today – said Jerzy Toczyski, President of GlaxoSmithKline Pharmaceuticals in Poland during a panel 'Effective cooperation for the benefit of health' . – Prices, for both innovative and generic medicines, belong to the lowest in Europe, and in the same time the level of the share in the medicine price covered by patients is one of the highest. The medicine refund policy must be formulated anew.

Participants in the panel agreeably proved that the health ministry, working currently on four laws called 'the pharmaceutical package' (refund law, law on registration office, clinical tests and the Pharmaceutical law), awaited by the industry and patients for a long time, should discuss them with all interested parties, to minimize many risks connected with introduction of the new law.

Judith Bidlo, Deputy Director in the Hungarian Supreme Health Insurance Fund, shared the experience of her country in introduction of changes to the refund system. Hungary has a contracting system based on results, there are also separate budgets for medicines and a separate one for hospital treatment, including the medicines used during such treatment. – We wanted to share the risk between companies and the government. Especially in the case of innovative therapies, there is always a risk if the real examinations would confirm the results of clinical trials – explained Bidlo.

Aurelie Vandeputte from the European Commission emphasized that the Commission does not work currently on political recommendations within the scope of medicine management policy for the member states, it wants only to prepare projects related to health care in consultation with companies, representatives of governments and patients' organizations.

Beata Chomątowska, 'Rzeczpospolita'

Protection of our health is one of the most important needs of every person.

Thanks to twenty years of development since the peaceful revolution, Poland has become a member of NATO and the European Union. Currently we are twentieth, perhaps twenty first biggest economy in the world pretending to gain membership in G20 group. Meanwhile, in terms of quality of health protection, Poland ranks more or less 25th in the European Union alone – it is in practice in the end of the ranking. From the viewpoint of the number of doctors, hospital beds, modern equipment, public and private resources in Poland are sufficient for correct functioning of the whole system. I think personally that even the funds in the system are sufficient, considering both public and private resources. The problem is posed by organization, management of resources, methods of financing, etc. It's the highest time to change organization and financing of health care in Poland. Health care requires courageous decisions, justified from the economic and social point of view. We need radical, even revolutionary change of paradigms in approach to health care. Such a challenge requires in-depth discussion among experts. That is why starting from this year health care will be present during the Economic Forum in Krynica.

The regional perspective for health care in Poland looks interestingly. In Europe, Poland fundamentally shares current issues with Baltic States, Romania and Bulgaria. Hungary, the Czech Republic and Slovakia have problems comparable to average or less affluent EU countries. Meanwhile, the countries to the east of Poland are not a reference for us, although our experience can be interesting for these countries.

Future challenges remain to be mentioned. On the one hand – ageing society, with increased longevity, on the other hand – more and more modern and expensive medical technologies, and all this in the context of uniting Europe, Lisbon Treaty and financing of access to innovations. Our colleagues from the EU deal currently with these issues. We need to discuss more basic ones.

XX, anniversary Economic Forum in Krynica will host, for the first time, the most outstanding health care specialist from Poland and Europe. My purpose is to ensure discussion pertaining to the subject matter, without political confrontations – top quality discussion. Starting from this year, the Economic Forum in Krynica will be a platform for discussion among health care experts setting direction of changes in health care in our region of Europe.

Maciej Bogucki
Coordinator of health care thematic track at the Economic Forum

Health Care at the Economic Forum

Within the scope of this topical track, we plan to organize a special plenary session with participation of ministers of health from a few European countries. Moreover, 10 discussion panels will be organized about the most important health care issues.

Competition among payers in the health care sector and its effectiveness

Discussion during the Forum will be preceded by presentation of a report about health care financing prepared by Ernst & Young.  It will be the basis for a debate during the panel entitled: 'Competition among payers in the health care sector and its effectiveness'. The phenomenon of extending average human life span can be observed in nearly entire contemporary world. In the same time, together with advancement of medical technologies, we can observe increase in not only the quality and variety of provided health services, but also their costs. As a result, even in highly developed countries, there are pressures to introduce more effective cost management in health care systems, including stricter mechanisms of allowances for public expenses on health care. One of the methods of cost reduction is introduction of competition among payers, thanks to which they would try not only to have impact on the price and quality of medical services, but also on patient's behaviours. The patient would be transformed from a passive receiver of services into an active one, equipped with information about the quality of competing services and service providers. Does competition among payers in the health care system lead in fact to better results achieved by the system? The presented report will constitute an attempt to answer this question.

Quality and effectiveness in Health Care

 EU countries including Poland face the challenge of providing their citizens equal access to more and more effective, but also costly medical procedures. During the panel 'Quality and effectiveness in Health Care' participants will discuss various aspects of effectiveness of health care systems in Poland and other EU countries, and especially accessibility of medical services with accepted quality, against the background of changes taking place in the market and in the financing systems. The discussion will be illustrated by indices describing effectiveness of the health care system in Poland as compared
to other countries.

Law and regulations in Health Care

The purpose of the panel 'Law and regulations in Health Care'  is to initiate discussion on the content and scope of the constitutional right for health care, and especially to define the state's obligations resulting from this law as well as to particularize the division of duties in the indicated scope between state and local self-government administration. Within the scope of the panel, participants will enter into discussion about the idea of basket of guaranteed health care services in the light of constitutional provisions and about the scope of autonomy of health care units and local self-governments as regards implementation of tasks in the health care sector.

Integration processes in the Polish health care – how to achieve synergy effect on the local and regional level?

Transformations of the health care system in Poland, but also in Europe and in the world, proceed in the direction of increased share of the private sector in financing and management of health care. Yet, it does not absolve the national or local self-government authorities from the responsibility to care for health of their citizens. Especially local self-governments, which are statutorily assigned – as their own tasks – with the issues related to health care, should devote especially much attention to this topic. That is why during the panel: Integration processes in the Polish health care – how to achieve synergy effect on the local and regional level? – participants will debate how to build a coherent system of complex care for patients and reconcile the requirements – to a large extent independent from one another on the ownership level – basic Health Care Units, specialized out-patients' clinic treatment and hospital treatment.  The discussion will also try to express the opinion  if the state – as the major payer (National Health Fund-NFZ) and regulator of the national health policy (Ministry of Health) can and should influence formulation of health care strategy, including also the local level.  Can privatization be reconciled with the needs of district citizens, who want first of all free-of-charge – within the scope of the system of Common Health Insurance – health care? How to achieve synergy effect and reconcile so diverse groups of interest?

Also the following panels will be held within the scope of this programme path:

1. Importance of e-health for the country's economy (e-Health for the Economy) – influence of ICT on transformation of the health care system.
2. Public Health – challenges for Europe.
3. The role of private health insurance in financing health care systems.
4. New treatments – remedy for a healthy and wealthy society.
5. Effective partnership for healthier society.

Moreover, panels are prepared on investments in Health Care, (sources of financing, type and level of application of funds) and access to innovative medicines in Central and Eastern Europe.