As indicated by conducted studies, health is mentioned by the bigger part of the society as the most appreciated value. It also has the greatest impact on all aspects of human life. In recent years, the traditional concept of health as „the absence of disease or infirmity” has been changed into the „physical, mental and social well-being.”
The level of the provision of medical services in Poland has shown an upward trend for many years. The reason that had contributed to this fact is the privatization of the medical sector. High quality of services in private institutions contributed to the increase of services in the public sector as well. Poland, in fact, is enriched with highly specialized staff and modern medical equipment, which favorably allocate country among the EU members. In 2014, according to the records conducted by Chambers of Nurses and Midwives, Pharmaceutical Chambers and Chambers of Laboratory Diagnosticians the right to conduct medical practice was possessed by 141.4 thousand of doctors, 40.1 thousand of dentists, 282.5 thousand of nurses, 35.5 thousand of midwives, 31.4 thousand of pharmacists and 14.7 thousand of diagnosticians. In comparison to the previous year, medical experts can notice an increase in the number of persons entitled to practice, and the highest was recorded in the group of pharmacists and laboratory diagnosticians (up to 3%).
Beyond the „availability” of medical staff, expressed by the correlation of the number of working with the patient to the number of potential patients, an important factor, which affects the quality of health care system- is a qualified medical staff. Dating back to 2014, 59.5 thousand of medical specialists were registered in Poland, which accounted 67.9% (by 0.3% more than last year) of all physicians working directly with the patient; 2.7 thousand of dentists specialists, which corresponds to 20.9% of the market. It is worth noting that approximately 10.5 thousand of doctors and 4.3 thousand of dentists with first-level degree specialization, worked in the health care system, but which currently are not specified among specialists. This group is steadily decreasing - older individuals finishing their practices, while some doctors with first degree specialization are using fast modes to improve their skills and professional qualification.1
During the recent years, there has been registered a significant activity in the development of selected segments of medicine in Poland. The interest in many fields, such as E¬-medicine, or e-health has noticeably increased. This can be explained by the continuous technological progress and growing market demand. In fact, nowadays commonly used tools and applications are being used for daily monitoring of patient’ health status. This segment of the Polish medicine is constantly being developed, and the provision of electronic services into the health sector is a priority for the coming years.
The given innovative form of the medical services’ and health care provision, which combines the elements of medicine and telemetry, is based on the use of modern communication technology, designed to break down geographical barriers and secure the exchange of medical data between specialists on distance.
According to the Central Statistical Office, in 2030 one can expect the increase in demand for health care services, which will be dictated by demographic changes that will in turn affect the increase in the number of people over 65 years old. CSO also reports that: „In the next 20 years the population of working age will steadily decrease to 20.8 million in 2030.”2 The progressive aging of the Polish population is a major challenge for the health care system. At the end of 2014, elderly population of 65+ years old composed of almost 5.9 million of people. In comparison to 2010, this number increased by 13.2%, while the total population decreased by 0.1%. Thus, the percentage of elderly people in the total population increased from 13.5% to 15.3%. One of the factors of the changing age structure of the population has been observed since 1992, lengthening the life expectancy.
In conjunction with the scale of the changes, a coordinated action in many areas of health and social care is evidently required, ranging from training of medical staff, the application of advanced technological solutions, to support the application of new technologies in the practical applications. The development of telemedicine solutions, in the light of projected changes, is not only a possibility, but a necessity, aimed at efficient use of human resources, physical health and social care as well as increase of its effectiveness in price-effect correlation.3 Despite the fact that legal and regulatory system in Poland has not define telemedice yet, one should emphasize the growing popularity of this form of medical care. Tools and applications that must support the patients and physicians, who care for them in a distance, are becoming increasingly easier in use and functionality. Devices, intended to perform home measurements and tests, are no longer a barrier even for the elderly people.
Centers for diagnostics of lifestyle diseases
Civilization diseases - are defined as occurring globally and the progress of modern civilization contributed to their spread. For this reason, the term can be also correlated with the „disease of XXI century”. This definition applies, however, to a particular time and place. The disease, once classified as civilizational, will remain such until humanity can deal with that problem, and because of that the morbidity and mortality are not reduced and do not lose a global dimension.
The National Research Programme defines the diseases of civilization as the greatest danger to the health of the Po¬lish population in the coming years. The list of civilization diseases includes: cardiovascular diseases (e.g. hypertension, myocardial infarction and stroke), cancer, kidney disease, diabetes and obesity, mental illness (including depression), diseases of dementia and alcohol dependence, drugs and communication disorders. For many years, one could have observed a steady increase in the incidence of allergic diseases, especially among younger patients. Increasing the availability of innovative treatments and preventive care will save the costs and allow to maintain a greater number of people in the active group. Particularly in those areas special emphasis on issues related to innovative solutions and prevention, diagnosis and treatment as a means of quick respond to the challenge of an aging population, should be placed. It should be noted that the longer people remain in good health, are physically and mentally fit, and respectively able to work – the longer they will be able to contribute to the growth of GDP.
It is expected that Centers for Diagnostics of Civilization Diseases will be created in Poland. From the initial phase of the project, the Centre would be available nationwide through the use of innovative technologies and telemedicine. Then, it is planned to extend those activities to a European scale. Centers will ultimately deal with, treatment of civilization diseases and scientific work – research, using the latest and most advanced technology. The aim of these projects is to provide comprehensive healthcare services and ensure the conduction of a scientific research, reaching the global level. Therefore, it would be right to say assert that the issued question is the future of medicine, which today, constitutes one of the largest and important markets in the world. In Poland, the healthcare sector is one of the least organized, so one should expect a significant demand for such services. Hence, investments in this area will involve a small risk along with attractive rates of return.
The platform of medical services
Polish health care system is characterized by a high level of complexity associated with the multitude of entities cooperating within it. Thousands of healthcare facilities of different sizes are operating in order to provide care for around 38 million of recipients. To ensure effective supervision of the system and present a medical care to those in need, its computerization is essential- emphasizes the Ministry of Health.
Polish Ministry of Health plans to spend high sums of money on electronic platform, which part comprises of written descriptions. Projects that are intended for implementation in 2030 by the Ministry of Health are as follow:
• P1 - Electronic Platform for Collection, Analysis and Sharing of digital Medical Health Events;
• P2 - Medical Registry Platform - a versatile informational tool, destined for keeping records, providing electronic services, as well as ensuring the optimum level of safety;
• P3 – Health Registry Platform - systems associated with reconstruction, adaptation, maintenance and monitoring of records and other health care resources by public authorities, including the state administration and local government;
• P4 - ICT - systems of informational domain system in health care that deal with improving business processes related to management and access to information in the health system,
• P5 - Electronic platform for telemedicine consultation of the Ministry of Health, the National Health Fund and a network of highly specialized hospitals, which gives one a good chance of obtaining support for consistency between different telemedical projects in Poland.
• P6 – Reinforcement of the strategy for Polish public information of Liaison Institutions.
These solutions make possible the integration of all Polish medical facilities, so that the communication between selected institutions or access to the patient card in various places around Poland will be unlimited. Joining the www project of telemedical systems would surely facilitate contact between patient and high-class specialist, increase access to life-saving treatments, as well as shorten the time between the occurrence of e.g. heart attack and the initiation of treatment. An additional benefit lies in the fact that it will raise the level of knowledge about illness prevention and treatment, due to the exchange experiences as well as direct participation in operations through Internet connections. It will significantly raise the quality of services and reduce the degree of mortality among patients, for instance, from heart or circulatory system diseases.
Polish market of aesthetic medicine in recent years is one of the fastest growing - according to the Lea Future company. Polish sector, in this respect, is growing faster than the Asian market, which recorded 12% of growth per year. The slowdown was noted only in Southern Europe. Experts emphasize, however, that such sudden acceleration is taking place due to the fact that the Polish market of aesthetic medicine is still a developing market.
According to the latest market analysis, Polish customers much more likely to benefit from the aesthetic medicine treatments, spending in 2014 in clinics of plastic surgery and aesthetic dermatology almost USD 1 billion. Widespread interest and general availability of services caused a 15% increase in 2014 and reached up to 20 % in 2015, thereby increasing the market value of over USD one billion.
A segment of aesthetic medicine, which recorded the largest increase, is a plastic surgery. According to the report of the research company PMR, Poles spent PLN 200 million for plastic surgeries and beauty treatments in 2013. Among the most commonly performed procedures one can distinguished breast augmentation, facelifts and nose correction. In turn, among less invasive treatments the most popular are the treatments with use of botulinum toxin and fillers. The PMR research company in its press-release presented that the most important trend, noticeable in the market, serves a diversification of the offer in terms of new technologies, which allows one to change existing products (such as the use of thread in lifting) to new, none previously proposed services (e.g. Aesthetic gynaecology).4 5
Most of the companies on the market, that are providing services in the field of broadly defined aesthetic medicine - in particular plastic surgery- have modern facilities, with separate sectors for consulting services and part of the hospital or treatment facilities. The development of plastic surgery, as well as the growth of technology can increase standards of living, and often its rescue. In Poland, the number of patients that is in need for such benefits constantly increases. Polish doctors are counted as world-class specialists with not a minor importance achievements. For the first time performed face transplantation on the territory of Poland (2013) was recognized by the Annual Meeting of the American Society of Reconstructive and Microvascular Surgery as the best reconstructive surgery in the world. The operation, which was carried out in Gliwice Oncology Centre by the team led by prof. Adam Maciejewski, was the world’s first face transplantation, performed to save live.
Plastic surgery in Poland, in some cases, is refunded by the NFZ (National Health Fund), but this applies to situations of threatening the health / life or that, being congenital or acquired. It should be noted, however, that these are the benefits of one of the longest waiting periods: the average time for which the patients have to wait is from 4 to 5 months. Therefore, they often decide to take advantage of paid services in the private medicine sector that are available to them immediately, in a comfortable medical facilities. Prospects for the development of the aesthetic medicine market in the incoming years are very promising, due to the huge demand among people, which is indifferent to current state of the market.
Cosmetology and the entire cosmetic industry are currently very popular segment of the Polish market. Poland is one of the two European countries where cosmetology is taught at the university level, such as BA and MA level. The amount of students interested in this direction has not decreased since 1997, when the course of this type was introduced for the first type. In 2014, the cosmetics industry in Poland provided work for about 19 thousand of people and this number is keep on growing till this day. Among them one can find both experienced staff and world - class scientists.
Cosmetology - is a kind of science that specializes in maintaining, restoring or improving human appearance. It deals with improving the quality of life of patients, and is closely related to the aesthetic medicine and plastic surgery; however, uses less invasive methods of treatment. The methods of cosmetology comprise mainly of cosmetic and beauty treatments, dietary interventions, and rehabilitation. The development of Polish cosmetic companies started about two decades ago, but has accelerated since country’s accession to the EU. The industry is still characterized by the growing trend, showing an average annual growth market consist of the hair care products (EUR 616.5 million - 18.1 % in 2014), and skin care cosmetics (EUR 582.4 million - 17.1 %) that together constitute over 35 % of the market. Other important categories include: perfumes (13.1%), cosmetics for men (11.2%) and colour cosmetics (10%).
Poland was the 6th world’s exporter of cosmetic products and personal hygiene in 2012. Polish beauty brands are well recognized, but only few consumers (even in Poland) draw attention to the fact that the product comes from Poland. About 60% of Polish cosmetics exported to the EU market, 18 % to European markets, including Russia. The rest is sold throughout the world - Polish cosmetics are sought even in New Zealand. According to analysts, the Polish market of cosmetics follow the path of growth, because the long-term segment has very good development prospects. The key factors, which affected this tendency, are, for instance, the macroeconomic situation and trends in Western Europe.
Production of Generic Drugs
Nowadays, when the demand for medical services is rapidly growing, relatively cheap generic drugs bring large benefits to society: provide patients with access to safe and effective medicines of high quality; and health systems in the EU countries – with a chance to save more than EUR 20 billion per year. Thanks to these savings, the state can more easily find the resources to pay for the new, innovative treatments.
Polish pharmaceutical market is, in terms of sales value, takes 6th place in Europe - sales at the end of 2015 constituted nearly PLN 29.9 billion, a 4.8% more than in 2014. From the perspective of value terms, the market grew by nearly PLN 1.4 billion, while the value of the refund at the end of 2015 showed less than PLN 7.9 billion (+ 3.5%). That’s about PLN 264 million more than in 2014.6
In 2015, Polish pharmaceutical market could boast with a significant share of generic drugs drugs, as it constituted 85% of prescription medicaments. They are of a great popularity due to the low price if compared to the original drugs. Manufacturers introducing to the market a drug, which contains the same active substance and have the same pharmaceutical form as the original drugs, and bio-equivalence studies confirm their effectiveness. It is also estimated that „generics” constituted about 65 % of all drugs, sold in 2015 (non-prescription medicaments, and others). For comparison, generics in Italy occupied only 2% of the market in terms of value and 4% - in terms of quantity; Germany 22,7 % and 41% respectively; while in the Czech Republic - 32 % and 55 % respectively.
The price of generic drugs placed on the market, is an average of 25% lower than the price of the original drug before patent expiry. This difference increases with the passage of time and often reaches up to 90%. Thanks to the pharmaceutical drugs of this type, increases also the purchasing power of poorer buyers. Launching „generics” also affects the possibility of increasing the funds, intended to reimburse and develop innovative products in the pharmacy.7Source:
1. Central Statistical Office in the publication „Health and health care in 2014”.
2. Central Statistical Office in the publication „Population prognosis for years 2003-2030”.
5. EMI report - Pharmaceuticals& Cosmetics Sector Poland, March, 2013.
6. Report: “Generic medicine ensuring patients’ access to efficient, safe and modern therapies”, Warsaw, 2007.