What can you tell us about the ongoing recovery of state debts for medication?
The state’s debts to medical manufacturers, distributors and pharmacists are very high and their recovery is a long and slow process that deeply affects all parties. A major problem is that, since companies cannot recover their money in a reasonable deadline, the industry is still within difficulty as finally these late payments are mostly made.
The problem is not only the costs of the money but also the increased risk of bad debts. ARPIM is a supporter of the European Directive on Late Payments which will be implemented in Romania too in a few years and we see it as a strong incentive for governments to become responsible economic actors.
Developing new drugs takes almost 15 years and needs a long-term investment of up to EUR 1.5 billion for one new molecule. It also requires a reliable and predictable market environment.
How could the Romanian health system improve, from ARPIM’s perspective?
I believe that we cannot have a wealthy country without a healthy population. As Romanians and Germans both say: if you have good health, you have everything you need. Expenditure on the healthcare system is 3.6 percent of annual GDP. This is among the lowest in Europe, below the EU average of 8 percent. It is important that at least in the medium to long term, Romania finds more resources for its healthcare system. Facilitating the development of the private healthcare system to a larger extent could help. Another solution would be to provide access to innovative treatment by introducing new medicine on the reimbursement list.
What could the Romanian health system learn from the German one?
I see one important difference in the funding of the system. The burden of people not contributing to the health system is not compensated for by the active contributors but by the state. For example, the state pays health contributions for the unemployed.
I also consider the role of family doctors in Germany as an advantage as they are the ones who know best the general situation of patients’ health and also their social environment. The principle there is “as much as possible out-patient – as little as possible in-patient” and innovative and efficient products can be very valuable to implement this principle successfully. As far as family medicine is concerned, there is still room for improvement in Romania.