Download - Modernising the Serbian health system
Modernising the Serbian health system
Future improvements
SOURCES: Eurostat; Health Policy Institute; IMS Health; Serbian Association of the Manufacturersof Innovative Drugs (INOVIA); World Bank; World Health Organisation.
Supported by
Second Serbia Health Project(approved by World Bank in 2014)
Efficiency improvements:
US$40m
capitation system in primary care & payment mechanisms based on diagnosis-related groups (DRGs) in hospital care.
The context Healthcare spending is not delivering the expected health outcomes
aims to improve the efficiency and the quality of Serbia’spublic healthcare system, but progress on HTA has been slow. Serbia wants to join the EU by 2020
Healthcare covered under Chapter 28 (consumer andhealth protection) in accession negotiations. Serbia hasrecently joined the EU’s health programme for 2014-20,which, among other things, seeks to contribute toinnovative, efficient and sustainable health systems.
Serbia encapsulates many of the health challenges facing less developed Balkan countries.Its healthcare system is decentralised and fragmented in places, and levels of out-of-pocketpayments and corruption are high. The country lacks a transparent and comprehensivesystem of assessing the value of its healthcare investments and determining how to payfor them. All of these issues undermine access to healthcare and contribute to relativelypoor health outcomes.
SERBIA
BOSNIA & HERZEGOVINA
SLOVENIA
BULGARIA
CROATIA
REPUBLIC OF MACEDONIA
MONTENEGRO
ALBANIA
ROMANIA
10.49.6
9.28.4
7.86.56.4
5.95.6
Healthcare spending as % of GDP
The key problems Major concerns about corruption in healthcare, the public healthfund and the process of evaluating new health technologies
Life expectancy and death rates
Poor financial situationof the public health
fund undermines thesustainability of thehealthcare sector.
Absence of a sustainable, comprehensiveand transparent system
to evaluate and procure new health technology.No national Health Technology Assessment (HTA)agency exists, and Serbia is not a member of the
European network for Health TechnologyAssessment (EUnetHTA).
Issues with corruption:out-of-pocket spendingmostly in the form of “informal”
co-payments, estimated to be
36.6% of totalhealthcare expenditure.
The consequences Weak patient access to healthcare
Access to medications in Serbia is restricted
Patients are not getting the care they need
Example: just Between 2010 and 2012 just one of the 139 new medicines to receive market authorisation was
approved for reimbursement in Serbia,
compared with 44 in Bulgaria and 27 in Croatia.
200-300 patients are getting prescribed treatment for
hepatitis C out of 2,000 potentially eligible (excluding new-generation drugs).
Serbian life expectancyat birth is more than
5 years shorterthan in EU(2013 data).
Serbian standardised death rate from cancer is
50% higherthan in EU(2012 data).
Efforts to improve healthcare efficiency, quality and health technology assessment need to be stepped up