Other major problems to which the report points are drugs consumption, with Romania being on the penultimate place in Europe, after Bulgaria (100 euros to 430 euros elsewhere in the EU), and a delay in the marketing of new drugs by at least 2.5 years than elsewhere in the EU.
The report shows that Romania is spending too much on hospitals (45 percent of resources compared with 40 percent in Organisation for Economic Cooperation and Development countries, relatively small on primary care, relatively high on drugs, although co-payments are high (50-55 percent), and also that 8 percent of the sick is using up 70 percent of the resources.
The report also claim that money has been spent on unfinished programmes, including one to gauge the overall health state of Romanians, which results have not been centralized yet.
Data centralisation is highlighted as a major problem to the entire system, along with non- application of clear therapy guides and clear priority criteria.
The report also points to inefficient price subsidising and regulation.
‘Brutal and inconsistent administrative measures have been attempted to cut drugs spending (including setting the minimum price at Eu levels, underrating exchange rates, price freezing, administrative regulations for the prices for proprietary, original and generic drugs). Such measures have often had contrary effects, for instance a decline in the market for generic drugs.
There have been instances of fraud that 2-3 years ago were valued at 10 percent of the budget of the National Health Insurance House (CNAS) that could have been better controlled. Moreover, the Government does not pay penalties for delays in its payments to pharmacists and drugs distributors, as it has delayed such payments every time it did not have money.
Access to care is another major problem with the underprivileged (rural area people and the poor). In addition, the Government is limiting the number of pharmacies under various regulations,’ says the report.
SAR comes up with some suggestions, including rationing the package of medical services and drugs covered by insurance to a level that is financially sustainable; setting up national priorities based on epidemiological studies, and identifying priority therapy areas for which resources for treatment and drugs should be evenly distributed.
SAR also suggests transparent public debate on such therapy areas, the list of drugs with subsidised prices, public policy measures in the field of healthcare as well as making treatments official in therapy guides, to the extent of the possible, so that they may help standardise treatments that would avoid arbitrary decisions, such as treatment using a much too expensive drug.