Czech Health Authorities Take Note as New Slovak Health Minister Set to Push Reforms Ahead

Czech Republic, Slovakia Take Different Approaches to Health Reform

In an interview with Pharma Marketletter, Czech Deputy Health Minister Pavel Hrobon gave his view on the reform efforts in the Czech Republic and Slovakia, which shared a common healthcare system until 1994, as parts of former Czechoslovakia. Discussing reform efforts in Slovakia, Hrobon said that the country had been through a substantial healthcare reforms during 2002-2006, but that the current government was "undoing" changes that had already been implemented. Hrobon added that for a while Slovakia showed uncertainty over it policy direction, stating that Slovakia's decision making could do with improvement.

Commenting on the Czech Republic's healthcare reform, Hrobon said that the process of real reform had only started by the end of 2006. At the start of 2008, the Czech Republic implemented a new law on drug price and reimbursement (P&R) which complies with the European Union (EU) transparency directive(see Czech Republic: 17 October 2007: New P&R Regulations Expected for Czech Republic in 2008). When asked whether he saw the danger of drug-spending cuts merely leading to higher costs elsewhere in the health system, he replied, "Actually I do not, at least not in the Czech Republic. The times of double-digit growth of the market are gone." Hrobon's main priority at present will be the reform of the health-insurance system, where health insurers will be transformed into "responsible purchasers of healthcare" (as termed in government legislation; see Czech Republic: 18 April 2008: Czech Government Approves Draft Act on Healthcare Insurance).

Slovakia Gets New Health Minister

Following Health Minister Ivan Valentovic's resignation on 3 June, Slovak Prime Minister Robert Fico appointed Richard Rasi, director of Slovakia's largest teaching hospital, as the successor. Former Health Minister Ivan Valentovic cited personal reasons for his departure, brushing aside speculation over his poor performance. Valentovic reduced healthcare fees introduced by the previous government of centre-right Prime Minister Mikulas Dzurinda and reduced the VAT rate on pharmaceutical products considerably. However, the trained doctor and former manager of a state health-insurance company failed to reduce the debts of the public health sector during his two years in office. Instead, the health sector incurred even higher debts. The newly appointed Rasi announced that his priority will be "healed and satisfied patients and satisfied healthcare workers." According to Tomas Szalay of The Health Policy Institute, Valentovic did not help the healthcare sector and failed to carry out many improvements, including the informatisation of the healthcare sector and a catalogue of healthcare services. Rasi, will have no less political pressure to deal with in pushing through such infrastructural changes, Szalay noted. Valentovic's departure is the third resignation from Fico's cabinet, and follows the resignations of Defence Minister Frantisek Kasicky and Agriculture Minister Miroslav Jurena. The most controversial aspect of Valentovic's tenure was the law banning private health insurance companies from making profits in the mutual health-insurance system, a move that sparked a number of litigations against the Slovak government (see Slovakia: 21 January 2008: Private Health Insurers in Slovakia Demand US$656-mil. Compensation for Lost Profits).

Outlook and Implications

Healthcare reforms are never easy, and in the case of the Czech Republic and Slovakia future reform efforts seem to be under way. In the Czech Republic, a continuation of cost-containment-focused policy is expected together with the reform of the health-insurance system. In order to improve the financial situation in the system, the Czech government introduced healthcare fees as on 1 January 2008, whereby patients must pay a 30-koruna (US$1.46) fee per medicine prescription, as well as paying for visiting a general practitioner (GP), specialist, dentist, clinical psychologist, or clinical speech therapist (see Czech Republic: 3 September 2007: Co-Payments to Be Introduced Czech Republic in 2008).

Hrobon's outlook on the growth of the pharmaceutical market is clearly not very optimistic for the pharmaceutical sector in the country, and no immediate improvement in operating conditions for drug manufacturers can be expected. The positive aspect of healthcare fees is that health-insurance companies have been able to save 2.6 million koruna, which Czech Health Minister Tomas Julinek may be able to use to cover the costs of expensive medicines (see Czech Republic: 24 April 2008: Co-Payments Have Reduced Unnecessary Visits to Doctors, Says Czech Health Minister).

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