Just what the doctor ordered
With the local pharma market given a recent dose of adrenaline, Corina Mica talks to Roberto Musneci, general manager of market leader GlaxoSmithKline Romania
Romania is the right place to do business and has made steps forward, but there are still problems, says Roberto Musneci.
“There are sectors where opportunities will be immediate after EU accession, and these include telecom, banking, consumer goods, infrastructure, defence, FMCG, commercial and private real estate, tourism and IT,” he says. “The pharma business has its light and shadows.”
His sector, he argues, needs more and better healthcare at a sustainable cost.
“There is a large unmet need in this sector,” he adds.
But there are new reforms that do have the support of the industry as the Government has recently assumed responsibility in Parliament for a package of laws that tackle the ailing healthcare sector.
“There are new laws that will take at least a year to go through, especially considering the by-laws,” says Musneci. “The healthcare system is always seeing a crisis, but the situation now is much better than in 2003. Also, a very good element is the new spirit of collaboration, at least publicly declared, between the Minister of Health and the Prime Minister. Also, credit should be given to the President, who took a keen interest in the healthcare system and acted accordingly.”
The industry at large misses answers to basic questions.
“For example, what are the epidemiological needs of this country? There are very poor statistics in this respect,” he says. “Then, are the prices in Romania higher or lower than the EU average? A recent study shows that in general Romania is well below the EU average. Is the health budget allocation enough for a country with this GDP? The average health budget allocation in EU countries is seven to eight per cent of GDP, in Romania this ranks between 3.5 and 3.8 per cent of a much lower GDP. There is a Government commitment stated in the electoral campaign which promised to move it to six per cent by 2007, and the question then arises: are we really doing this?”
Every Romanian citizen pays a monthly contribution to the healthcare system, which may not be sufficient for the current needs.
Data from the Ministry of Finance for the first four months of this year shows the total tax collected is 18 per cent higher than expected, which could indicate that new initiatives, such as the flat tax of 16 per cent on income and profits, is making more people pay up – the result of which would be an increase in health contributions.
“We need the Ministry of Health, the Ministry of Finance and the National Healthcare Insurance Commission to have a joint database telling us where we are and then we can start a constructive dialogue,” says Musneci. “We don't need to panic each month and we don't need to see old and retired people queuing in front of pharmacies for fear they might run out of drugs.”
Valid information is needed to know what type of measures and resources are necessary.
“If there is a political will, at the Prime Minister and Presidential level, these can be drawn in a relatively short period of time,” says Musneci. “By the end of 2006 serious mapping of measures have to be taken for people to be guaranteed access to healthcare. Overall, in one year healthcare funding could go to four per cent and up to six-seven per cent in ten years' time, but we need a shared strategic vision.”
Fit for the union
With EU accession just around the corner now, is the local legislation what Romania needs to meet the harsh demands?
“The drug law is essentially in line with the EU directive,” says Musneci. “It is an extremely important law which we fully support. At the same time, norms have to make sure the spirit is fully implemented. With the right attention, in two to three years this will happen, also considering EU accession, the funds and the economic development of this country, Health Minister Nicolaescu needs credit for courage in pushing forward such a package of laws.”
A large downside is, in Musneci's view, the fact that healthcare is still considered an expense rather than an investment. “There are more and more scholars and politicians in Brussels that raise this issue [of healthcare as an investment], which leads to a longer life expectancy and a more productive life for people,” he says. “Romania has a life expectancy ten years shorter than the EU average, and this also comes from access to healthcare, lifestyle and access to medicines. This is a cultural change that will take time to happen. Awareness campaigns are needed to support this change in time. One element that an ideal healthcare environment should have is a perfect blend between private and public systems. The private sector is almost always more efficient.”
If the middle class can access private healthcare, which is then deductible from tax revenue, this could be an element of rebalancing the allocation of resources, he says. “You must have a complementary powerful role of private insurers, which could offer private healthcare packages or basic packages for a cluster of people that can afford that,” says the general manager.
“This is a right direction, which needs to be supported. The law of private healthcare has seen people make various comments about occult groups of interests, but the truth is that as long as private operators can deliver, they are welcome in this group of interests.”
Musneci's taste of the medicine business spans over 15 years of work within the group, which has spread through various mergers and acquisitions to become the multi-named brand it is today.