pro east - private healthcare system

8/8/2019 Pro East - Private Healthcare System

1/33

THE PRIVATE HEALTHCARE SYSTEM

IN ROMANIA

General Information

November 2010, Bucharest


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


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


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.


4


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



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%.


6

0

100

200

300

400

500

600

2008 2009 2010

Estimated privatemedical services in Romania

Value in millions Euro


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.


7


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.


8


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


9


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


10


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

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/


12/33

1212

Major private Outpatient Medical Centers in RomaniaContinued slide 11


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/


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


13


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)


14


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).


15


16/33

Private hospitals in Romania


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


17/33

Private hospitals in RomaniaContinued slide 16


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


18/33


19/33

Synoptic table private hospitals in Romania

and Bucharest


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


20/33

Private hospital location -

existing and new projects untill 2013

Pro EAST Consulting

20


21/33

The Major Private Healthcare CompaniesThe private medical services market estimated

at 430 mil euro in 2009


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


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.


22


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.


23


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)


24


25/33

25

Fee Schedules for Private Hospitals located in Bucharest.


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


1000-1200 EUR 500 EUR (without


Laparoscopic cholecistectomy 1098 EUR (without


1527 EUR (included


1200-1600 EUR 700 EUR (without

hospitalization)

Physiological birth 1902 EUR (without


1707-1829 EUR

(included


1516 EUR

Cesarean birth 1342 EUR (without


2376 EUR (included


1760 EUR

Mammoplasty 976-1951 EUR (without


2583 EUR (included


3000-4000 EUR


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).


26


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.


27


28/33


29/33


30/33

APPENDIXES


30


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).


31


32/33

Appendix no 2

List of Major Pharmaceutical Companies (2009)


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


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

pro east - private healthcare system

Documents