Despite the global R&D excitement around oncology, cardiovascular death still remains the world’s largest killer, and according to OECD data, accounts for roughly a third of all mortalities. This trend is no different in Poland. Nevertheless, the country is taking on the challenge head on, and is considered a leader in the field, recently highlighted by the January 2018 appointment of leading cardiologist, Łukasz Szumowski, as Minister of Health.
“We now have a cardiology ecosystem that is significantly better than many years ago”
Piotr Ponikowski, Polish Cardiac Society
Mirosław Wysocki, national consultant at Poland’s national institute of Public Health, explains that within “the treatment of acute coronary episodes, the hospital fatality rate hovers around four to six percent, which is one of the lowest in Europe.” This view is echoed by world-renowned cardiologist and president of the Polish Cardiac Society, Piotr Ponikowski, “From the perspective of a cardiologist working everyday with patients, we have experienced positive change and drastic improvements over the last 20 years, and we now have a cardiology ecosystem that is significantly better than many years ago,” he posits.
A major part of this positive shift is due to the country’s successful implementation of a national network of cardiology centers, though Ponikowski acknowledges that “these centers are at the top of the treatment pyramid and only entail one percent of all cases. What really matters is the base of the pyramid, building up a coordinated system that allows patients that suffer from acute coronary syndrome to be properly treated”. Nevertheless, this approach has led to Poland being one of the “European leaders in the interventional treatment of acute coronary syndrome with around 90 percent of patients being treated.”
Ponikskowi equally holds a more holistic standpoint and believes the Polish cardiology ecosystem has concerns “that are paradoxically linked to the success of Polish cardiology as patients are now living considerably longer and we are witnessing more and more elderly patients with comorbidities… therefore, cases are a lot more complex and they require a much broader approach to treatment, rather than just attacking a single cardiac disorder. This trend is easily explained statistically as there is a rising number of heart failure cases, the end result for many patients after years of chronic issues.”
The first step, and next challenge, along this pathway towards complete heart care is post-discharge treatment, and recently the Polish cardiac society have developed a structured approach with the government that allows patients to receive post-discharge care from physicians. Additionally, the society has met with the government to discuss a new national program for prevention, called ‘The Heart’. “This campaign will be directed towards the entire nation and specifically the 12 million Polish people that are at risk of cardiovascular problems, and the one million that are already affected.”, explains Ponikowski. He goes on express that this move means Poland is “attacking each distinct area of the cardiovascular chain: prevention, treatment and post-discharge. We now view the patient as more of partner, working with us along each step of the path.”
The nation’s focus on cardiology is clearly portrayed in the pharmaceutical sector. AstzaZeneca and Servier hold strong market positions, and Bayer are the third largest player in terms of sales, and according to IQVIA data, the German manufacturer’s cardiovascular wonder drug, Xarelto®, is the most sold drug in Poland, more than double its closest competitor. Despite this positive positioning for the therapeutic area, Ponikowski acknowledges that “every technology is not always required, and we want to help Poland understand what the nation needs, and which innovations should be truly valued and rewarded in cardiovascular care”. Therefore, “we must work closely with all parties involved to build a strong value chain of prevention, awareness and management of care so Polish patients can receive world-class cardio treatment.
Writer: Matthew Fsadni