One of the most salient challenges crippling Hungary’s effort to move the health agenda forward is the mass exodus of healthcare practitioners—placing significant pressures on an already overwhelmed system. “If we take the case of pathology as a small specialty among other important specialties in Hungary, we are only 250 pathologists at work in the country,” observes Dr. József Timár, president of the doctoral council at Semmelweis University. “This figure is half of what is really needed to respond to local demand. Approximately 10 – 20 percent of Hungarian pathologists migrate to Western Europe and that is triggering a shortfall of experts in local hospitals, especially for some rare diseases.”
“One of main factors provoking the brain drain is high asymmetry in doctors’ salaries when comparing the Hungarian market to the Western Europe, bearing in mind that the workload in Hungary is usually double that of many other European countries,” underscores Timár.
Such circumstances have invariably factored into the way healthcare practitioners approach patient care in Hungary, requiring much more tailored strategies from pharmaceutical companies when executing promotional campaigns and commercializing products. “GPs in Hungary tend to participate in a lot of events, congresses, and educational seminars—but the type of therapies prescribed has been changing only very slowly,” analyzes the country manager of Berlin-Chemie Dr. Péter Oláh.
For example, we have an antidiabetic product whose indication was approved for treating pre-diabetic patients. We have been promoting this new indication to GPs and specialists for more than six months, but we realized that doctors are already overworked and display limited interest in what is, after all, a rather preventive indication. I think this phenomenon is symptomatic of the current healthcare system in force in which the insurance fund offers little incentive to physicians focus on prevention. Additionally, over 200 GP positions are empty in the country, leading to oversized patient pool for the rest,” he reflects.
Other companies have chosen to dedicate their efforts to first understand the entire care spectrum, particularly from a patients’ perspective. “For instance, we developed a questionnaire in collaboration with six leading hematologists, the myeloma patient organization, and an independent research company to look at what patients with myeloma really experience or encounter,” explains Nienke Feenstra, Takeda’s commercial lead in Hungary.
“Through in-depth interviews with these patients, we assess both technical aspects, such as first symptoms and treatment regiments, and psychological considerations, such as their personal sentiments, emotional responses, or access to informational support. Essentially, our aim is to obtain a comprehensive and meticulously detailed overview of the total care flow and its unmet needs from a patient perspective for a particular disease first, in order to tailor our approach and address these needs simultaneously when bringing a product to market,” she continues.
Similarly, Danish dermatology specialist LEO Pharma has adopted this same notion of patient-centricity, but applied it in a more non-conventional fashion, relieving their sales force to focus exclusively on conducting and gathering in-depth market surveys extending to both the patients and doctors. “Following our research we soon realized that the dermatologists are only focusing on treating skin diseases without adequately recognizing and addressing the corresponding psychological anxiety of patients with psoriasis,” recounts the affiliate’s country manager Dr. Andrea Bondar.
“Many doctors have also said that they weren’t properly equipped to effectively handle the frustration of the patients. As such, we created an online portal for doctors called dermacare.hu to help them acquire the necessary support. The primary objectives of this portal were to help healthcare practitioners stay up-to-date with the latest scientific advancements, better understand the needs of the patients, and establish open communication channels with other doctors in the community,” details Bondar.
Exeltis, a mid sized Spanish enterprise specializing in woman’s health has chosen to pursue to more traditional models in light of prevailing market dynamics. “Our first entrance to the market was with a product that was entirely new, so we utilized a more traditional marketing strategy— engaging directly with gynecologists and organizing round tables. Hungary traditionally was not a price sensitive market with oral contraceptives, but is now becoming more so with the influx of generics,” exclaims sales and marketing manager Veronika Ferencz. “This is why it is very important to have a strong relationship, not just between our sales representatives and the gynecologists but pharmacies as well.”
In order to truly lead by example and provide the proper tools and support to raise the quality of care in Hungary, “Wörwag has taken a specific interest in raising awareness for the diagnosis and treatment of this complication by building up a network of neuropathy centers,” describes the managing director of Wörwag Dr. Éva Kádár. “This initiative began with the first center opening up in 1998, alongside the establishment of the National Neuropathy Screening and Education Center at Semmelweis University. Since then, this network has expanded to 13 neuropathy centers until today, and we have ambitions of doubling that number to have at least one center in each county by 2020.”
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