ZF Private Health. Harris Palaondas, SOFMEDICA, supplier of da Vinci robots: 1,300 robotic cases were performed in Romania last year, 85% in private health sector. In Bulgaria, 1,600 procedures were performed due to the reimbursement system

In Romania, there are 13 robotic surgery centres, 20 private and three public. More than 50 Romanian surgeons are certified in robotic surgery, compared to more than 130 surgeons in Greece. Government support is needed for future development of a robotic surgery program in several state hospitals. Robotic surgery can be used for urologic, gynaecological oncology, general surgery conditions. In Hungary, 700 robotic surgeries are performed in state hospitals.

Medical equipment supplier SOFMEDICA, part of the group with the same name, present in Greece, Hungary, Bulgaria and Cyprus, ended last year with a turnover of 35 million euros, expecting a 20% business growth in Romania this year.

“The company entered the local market in 1994, starting with equipment for chronic dialysis, and in 2002, with the first program of robotic surgery. There are 13 robotic surgery systems in Romania, 10 in private and 3 in public hospitals.” – Harris Palaondas, Business Director of SOFMEDICA, supplier of daVinci systems, told ZF Private Health.

Last year, in Romania, 1,300 cases were performed with daVinci technology, 85% of which were in private hospitals and the rest in the public system. Compared to Romania, Bulgaria performed 1,600 interventions with 11 systems, of which 60% were in the private system. In Hungary, where there are only state-run centres, 700 operations were performed with 4 systems.

SOFMEDICA has ended the last year with a turnover of €35 million in Romania, expecting an increase of 20% this year.

In all SOFMEDICA operating countries, there are 45 active centres benefiting from daVinci technology. Worldwide there are 7,000 such centres, most of them located in the USA.

“The investment in such a centre depends primarily on technology and program type, varying between 2 and 4 million euros. Robotic surgery has application on urology, gynaecological oncology, general surgery, abdomen, thoracic surgery, paediatric surgery, each hospital developing multidisciplinary programs,” added Harris Palaondas.

Romania’s potential for robotic surgery is twofold; this year, SOFMEDICA estimates 2,000 cases in local centres. “The key is state support, a level of reimbursement that doesn’t exist in Romania right now. Romania has double potential, there is an algorithm we use that considers a mix of imaging power, population and gross income per country. Romania has a potential of 4,000 daVinci robotic surgeries. Bulgaria, with a smaller population but with a reimbursement system has more cases. Hungary with 4 active systems in the public sector does 700 interventions.”

A reimbursement program is necessary to expand robotic surgery to public sector, so patients can have access to more hospitals. The state hospitals equipped with daVinci system are Carol Davila” Central Military Emergency University Hospital, Timișoara County Hospital, and Iasi Oncological Institute.

The private hospitals equipped with daVinci technology are Ponderas, powered by Regina Maria, Euroclinic, Medlife, Sanador, Monza (Memorial Hospital), Nord Provita Hospital, Oradea Pelican Hospital, St. Constantin Hospital in Brasov, Regina Maria Cluj and Medicover Hospital in Cluj.

“This year, we hope to implement 3-4 systems in the private sector, where each of our clients has 15-20% growth every year. Because of Covid-19, the private sector has offered services to more patients. Regarding the public sector, we rely on the National Cancer Sponsorship Program.”

In present, the three state hospitals are self-funding the robotic surgeries as Romania no longer provides a national program.

“Now there is a cancer program which requires further development and implementation. We are looking forward to incorporating robotic surgery and a first level of reimbursement. The Ministry of Health needs to understand that robotic surgery has economic and clinical value.”

The Ministry of Health no longer provides public funding for robotic surgery since 2013. The program was implemented in 2008, aimed at supporting the technological advancement in surgery and medicine. State hospitals which have daVinci technology must self-fund robotic surgery cases. Robotic surgery is a state-of-art innovation which can be used in various specialties.

The investment in a robotic surgery centre amounts to 2-4 million euros depending on the technology.

In Romania, more than 50 surgeons are certified in robotic surgery, compared to 130 surgeons in Greece.

“We offer training and education for healthcare professionals, providing a centre in Bucharest and Greece for development of robotic surgery skills. If the surgeon has access to the robotic surgery system, then the training progresses to the simulation phase and observation in medical centres. We support each program with clinical assistance, providing 3-4 months of training in the US and clinical support for each program.

Worldwide there are over 50,000 surgeons certified for the daVinci system. The learning curve is very short on robotic surgery; thus, the surgeon needs to complete 20-40 cases for outstanding results, compared to laparoscopy where a surgeon needs over 100 cases to become effective”, said Harris Palaondas.

SOFMEDICA has ended last year with €35m turnover, expecting 20% growth in Romania and €50m for the group as a whole.

“Robotic surgery is not something new, we installed the first system at Floreasca Hospital in 2002 and now it has developed to the 4th generation, it is a technology with many benefits, from reduced hospital stay and fewer re-interventions.”

He added that the plan for SOFMEDICA is to reach 30 robotic surgery programs in Romania, with 100-300 cases in each center.

Bucharest has a constant growth in terms of healthcare investments in medical equipment within the private sector, with Cluj and Iasi being the most developed.

“It is necessary for the state and the Ministry of Health to analyze the benefits of robotic surgery (…)Innovative technologies suffer a slow implementation process in Romania, compared to Western European countries.

The secret of success is to understand the value of the technology, to see all benefits and have a quick evaluation system from the government. An innovative technology offers cost reduction that is related to all the intervention or recovery procedure, but also savings made by a hospital on fewer recovery days. This is a proven economic benefit. An evaluation system would be a step forward for the patient to have quick access to this innovative technology.”

SOFMEDICA is currently working with 25 medical equipment manufacturers from US, Israel, France, bringing innovative technologies to the local market, with a focus on oncology, cardiovascular and neurology.