FROM NEXT TO NOW
As a signal of the market's bursting potential in the eyes of many multinational affiliates, Poland is often included in the
discussion as the "next" or "sixth" country for multinational affiliates invested in Europe after the big five of England,
France, Germany, Spain, and the United Kingdom. "The country can be considered as a 'sleeping giant,' when looking at the
overall population, the economic growth, and the fact that it is now an EU member," asserts Bednarz Bartosz, general manager
of AstraZeneca Poland, one of the fastest-growing pharma companies in Poland in 2010. "Given its size and population, one
could expect that Poland should somehow get closer to Spain in terms of the size of the pharmaceutical market," he adds.
Cezary Slediewski, President of PZPPF
However, the juxtaposition between a geographically massive, well-populated, and economically liberalizing market that is
cautious about creating the financial access for innovation has convinced many industry executives that pharmaceutical industry
development is still very much an ongoing process. "Naturally, the primary objective of the pharma industry is to continue
its mission to improve health standards and sustain profitability, whereas the primary objective of the national healthcare
system is to introduce more and more control over its spending, especially in the area of reimbursement," opines Anna Gajec,
general manager of French consulting house Cegedim's Polish business. Peter Koetsier, general manager of Bristol-Myers Squibb
Poland concurs, stating that "the transition to a free open market and a world of innovation will continue to be an evolution."
Drawing a more figurative analogy, Koetsier likens the healthcare system in Poland to an adolescent. "It has its adult moments
mixed with moments of being quite underdeveloped, and sometime a constant movement between the two."
Within this context, a better dialogue is called for between various stakeholders of the healthcare sector, including local
authorities and the pharmaceutical industry in order to reach a common goal—better health outcomes for Polish patients—and
to move Poland from "next" to "now."
Peter Koetsier, General Manager of BMS
DEMANDING A FASTER PACE OF CHANGE
Poland's accession to the EU has, of course, stimulated the competitive landscape and pushed local industry to align with
European standards and regulations. Consequently, the benefits that have come with joining Europe's exclusive club have also
fueled an appetite for further reforms and at a faster pace. Commenting on this two-fold effect, Michal Bichta, managing director
of Germany's Merck Group, which is present in Poland through both pharmaceuticals and chemicals, notes that "the socio-economic
situation has dramatically changed in Poland in the last 10 years, partly due to the fact that Poland became a member of the
European Union (EU), but also due to the evolution of the national economic situation. Poland is gradually applying more and
more European directives, yet at the same time, some existing regulations from the communist period still remain. Since Poland
is part of the EU, Polish people have started to look around and compare what is available in neighboring countries. This
awareness creates more pressure on healthcare services in Poland, as the population expects the country to be catching up
much faster than the current pace."
The rapid pace of reforms, however, is countered by a government that is keen to control spending. The result has been what
Cegedim's Anna Gajec describes as idiosyncrasies in the Polish regulatory and reimbursement systems. She notes, for example,
that Poland negotiated a 15-year transition period before implementing the EU's harmonized 8+2+1 data-exclusivity standard.
The regulatory environment is therefore typically characterized by long delays for reimbursement approval.
Jacek Barlinski, General Manager of Nycomed
However, as Health Minister Ewa Kopacz posits, due to limited funds at the National Health Fund's disposal, "The existence
of waiting lists cannot be avoided. It is important to provide equal access to services, taking into account, among others,
health status and acceptable waiting time for a given patient to receive service. In Poland, depending on health status, a
patient is granted urgent or stable status, which means that the order of patients is not only established on the basis of
the date of reporting to a doctor, but also on the basis of medical indications."
Strong economic conditions of the Polish healthcare sector will indirectly influence the security of funds for reimbursement
in a positive way. Numerous discussions within government circles are taking place regarding potential changes to the healthcare
system and medicinal reimbursement. Minister Kopacz says that "the draft legislation on the reimbursement of medicines, food
for particular nutritional uses, and medical devices has provided for the total reimbursement budget indicator at the level
no higher than 17% of expenditures on total healthcare, which guarantees that access to reimbursed products will be gradually
wider, along with increased the budget for total healthcare."
Total Market Value
But according to Gajec, draft legislation is not so clear-cut. With complexities in proposed scenarios varying significantly
from one to the other, building up long-term strategies in a capricious and ambiguous environment can be real challenge. "As
a consequence of these characteristics I would say that Poland is highly different to some others markets in the region and
that every single general manager in Poland must find a good, sometimes very specific, operational way to conduct business,"
Fully concurrent, Merck's Bichta notes that in Poland, "business is driven by change; planning years in advance seems almost
impossible in our country." However, adaption to local market specificities and the adoption of different cultures—in this
case, the demand for reform and the need for patient planning—is of second nature to Merck Serono. Having assisted in the
corporate integration of Merck and Serono in 2007, Bichta attests to the experience as an "alignment of mindsets and culture."
He recalls that "whereas the Serono legacy was customer-oriented, highly specialized, and focused on short-term results, Merck's
legacy was more focused on the general practitioners market and with emphasis on long-term growth and lifecycle management."
Very applicable to the disparities in the Polish market, "Merck Serono is today benefiting from both mindsets and cultures,
which have a very positive impact on the performance on both sites—pharmaceuticals and chemicals—in real terms." Merck in
Poland is a market leader in treatments for highly prevalent social diseases such as oncology, cardiovascular, and neurodegenerative
disorders and, according to IMS data, was the fastest-growing top-40 pharma company through the first three quarters of 2010.
Underscoring flexibility and diversity as a key to success in Poland, Bichta states, "It is important to be close to people
who understand the market from different angles, who show their expertise in certain areas. General knowledge is definitely
not enough; companies should be specialized."
Michal Pietraszek, General Manager of Apotex Poland