Private healthcare market in Russia and Ukraine 2011

The report is a comprehensive informational resource that presents and analyses the latest findings of an in-depth study of the private healthcare sectors in Russia and Ukraine. It provides current data on market size, structure and value within these countries, while providing incisive analyses of major trends and offering solid projections for 2013. The publication also features an examination of major players in the private healthcare market in the analysed countries (medical companies and insurers, as well as private hospital operators). It presents profiles of providers of private healthcare services as well as data on spending trends for various market segments, such as inpatient and outpatient services or health insurance. 

Key topics covered by the publication:

• Key events and trends: until 2011
• Forecast trends and influential events: 2011-2013
• Market size: 2008 -2013
• Trends and perspectives of the CEE health insurance market
• Profiles of the key players in health insurance markets
• Profiles of key private medical companies
• Private hospitals: number, details and prospects for future growth
• Analysis of other segments of the private healthcare market: dental segment, ophthalmology and gynaecology, as well as dialysis care
• Legal environment of health insurance and subscription markets
• Expected changes in the legal environment and their market impact

Find answers for the following questions!

• What are the perspectives of particular market segments on the private healthcare market?
• What are the main obstacles to investment in each countries?
• What are the expected changes in the law in each country and chances for their implementation?
• What would be more beneficial – to invest in private insurance or the medical subscription segment?

Report strengths

• Detailed company profiles
• Detailed information on health insurance
• Unique forecasts for private healthcare market values in each country

Companies mentioned in this report:

Extract from this report

• More than 68% of all medical organisations were privately owned in Russia in 2010.
• Russian medicine has been significantly reorganised since the fall of the Soviet Union, and this is reflected, in particular, in the current number of hospitals. This fell from 10,700 in 2000 to 6,500 in 2009.
• Out-of-pocket expenses accounted for more than 80% of total private healthcare spending in Ukraine in 2010.

Market commentary by expert

The dramatic situation in public healthcare has pushed more and more patients in Russia to choose private services. In Ukraine, the lack of a mandatory health insurance system is also leading to a situation when paying for healthcare services is a must. However, modern healthcare is available only to a small portion of the population. Perspectives for the future, due to the growing spending power and large populations are, however, bright and those segments can bring profits to wise investors.

Monika Stefańczyk, Head Pharmaceutical Market Analyst

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1. Report methodology p. 9

2. Executive summary p. 15

3. Reforms, events and trends in Russia and Ukraine p. 21

   • Russia p. 21
     • Key reforms, events and trends until 2011 p. 21
     • Predicted reforms and trends p. 23
   • Ukraine p. 25
     • Key reforms, events and trends until 2011 p. 25
     • Predicted reforms and trends p. 27

4. Overall private healthcare market p. 29

   • Russia p. 29
   • Ukraine p. 33
   • Comparative analysis p. 34
     • Shares of Russia and Ukraine in the overall private healthcare market p. 34
     • CAGR for private healthcare markets in Russia and Ukraine for 2011-2013 p. 35
     • Private healthcare spending per capita p. 35
     • Comparison of voluntary health insurance markets p. 36

5. Private health insurance market p. 37

   • Russia p. 37
     • Overview p. 37
     • Legal development p. 37
     • Market p. 39
     • Main players p. 42
       • Sogaz p. 42
       • ROSNO p. 43
       • Zhaso p. 44
       • Ingosstrakh p. 46
       • Reso-Garantiya p. 48
   • Ukraine p. 51
     • Overview p. 51
     • Legal development p. 51
     • Market p. 52
     • Main players p. 53
       • Providna p. 53
       • Neftegazstrakh p. 54
       • Ingo Ukraine p. 55
       • Axa p. 56
       • Ilichevskoe p. 57

6. Medical subscriptions market p. 61

   • Russia p. 61
   • Ukraine p. 63

7. Private outpatient clinics and hospitals p. 65

   • Russia p. 65
     • Private outpatient clinics p. 67
     • Private hospitals p. 68
     • Profiles of important players p. 69
       • Medsi p. 69
       • Family Doctor p. 71
       • SM Clinic p. 72
       • International On Clinic Medical Centre p. 72
       • NearMedic p. 73
       • Bud Zdorov p. 73
       • European Medical Centre p. 74
       • Doctor Plus p. 74
       • Center of Endosurgery and Lithotripsy (CELT) p. 75
       • Medicina p. 75
   • Ukraine p. 77
     • Private outpatient clinics p. 78
     • Private hospitals p. 79
     • Profiles of important players p. 80
       • Oxford Medical p. 80
       • Medikom p. 80
       • Kraplya Rosi p. 81
       • Medisvit p. 81
       • Boris p. 82
       • Medychnyi Tsentr Dobrobut p. 83
       • Eurolab p. 84
       • Poliklinika p. 84
       • LISSOD p. 85

8. Other areas of private healthcare p. 87

   • Dentistry p. 87
     • Russia p. 87
     • Ukraine p. 88
   • Ophthalmology p. 90
     • Russia p. 90
     • Ukraine p. 90
   • Gynaecology p. 91
     • Russia p. 91
     • Ukraine p. 92

9. Consumer behaviour and social trends p. 93

   • Drivers and barriers in private healthcare p. 93
     • Corruption and informal payments p. 93
     • Ageing population p. 95
     • Increase in purchasing power p. 97
   • Medical tourism p. 97
     • Overview p. 97
     • Prices p. 98
     • Russia p. 98
     • Ukraine p. 99
   • Patterns of medical care use p. 100
   • Attitudes towards private healthcare p. 102
     • Russia p. 102
     • Ukraine p. 103

10. Economic trends in Russia and Ukraine p. 105

    • Total health spending p. 105
    • Private medical spending p. 107

11. List of graphs p. 109

12. List of tables p. 113

13. About PMR p. 115

14. Contact PMR p. 116

List of graphs

1. Value (RUB bn) and change of the private healthcare market in Russia, 2002-2013      16
2. Value (UAH bn) and change of the private healthcare market in Ukraine, 2002-2013      17
3. Value (RUB bn) and change of the private healthcare market in Russia, 2002-2013      29
4. Value (RUB bn) and change of out-of-pocket spending in Russia, 2002-2013      30
5. Value (RUB bn) and change of other private healthcare spending in Russia, 2002-2013      30
6. Number of citizens (million) and percentage of those who are patients of commercial medicine in Russia, 2006-2015       31
7. Breakdown of chargeable medical services in Russia, by federal districts (%), 2008      32
8. Value (UAH bn) and change of the private healthcare market in Ukraine, 2002-2013      33
9. Value (UAH bn) and change of out-of-pocket spending in Ukraine, 2002-2013      33
10. Value (UAH bn) and change of other private healthcare spending in Ukraine, 2002-2013      34
11. Shares of Russia and Ukraine in the overall private healthcare market (€ bn, %), 2010 and 2013      34
12. CAGR for private healthcare markets in Russia and Ukraine, 2011-2013      35
13. Private healthcare spending per capita in Russia and Ukraine (€), 2010      35
14. Shares of Russia and Ukraine as a proportion of overall VHI market (€ bn, %), 2010       36
15. VHI spending per capita in Russia and Ukraine (€), 2010      36
16. Value of premiums and claims of Russian voluntary health insurance (RUB bn), by client category, 2009-Q1 2011      39
17. Breakdown of insurance premiums in Russia (%), 2010      40
18. Breakdown of insurance claims in Russia (%), 2010      40
19. Number of concluded (including active) VHI agreements in Russia, 2009-2010      41
20. Sogaz: voluntary health insurance premiums and claims in Russia (RUB bn), 2009-2010      42
21. Sogaz: number of concluded (including active) VHI agreements in Russia, 2009-2010      43
22. Rosno: voluntary health insurance premiums and claims in Russia (RUB bn), 2009-2010      43
23. Rosno: number of concluded (including active) VHI agreements in Russia, 2009-2010      44
24. Zhaso: insurance premiums, by categories of voluntary personal insurance in Russia (RUB bn), 2007-2010       45
25. Zhaso: voluntary health insurance claims in Russia (RUB bn), 2009-2010      45
26. Zhaso: number of concluded (including active) VHI agreements in Russia, 2009-2010      46
27. Ingosstrakh: voluntary health insurance premiums and claims in Russia (RUB bn), 2009-2010      47
28. Ingosstrakh: number of concluded (including active) VHI agreements in Russia, 2009-2010      47
29. Reso-Garantiya: voluntary health insurance premiums and claims in Russia (RUB bn), 2009-2010      48
30. Reso-Garantya: number of concluded (including active) VHI agreements in Russia, 2009-2010      49
31. Percentage of total spending on healthcare in Ukraine, by source of revenue, 2008      52
32. Value of voluntary health insurance premiums and claims in Ukraine (UAH m), 2008-2010      53
33. Providna: voluntary health insurance premiums and claims in Ukraine (UAH m), 2007-H1 2010      54
34. Neftegazstrakh: voluntary health insurance premiums and claims in Ukraine (UAH m), 2007-H1 2010      55
35. Ingo Ukraina: voluntary health insurance premiums and claims in Ukraine (UAH m), 2007-H1 2010      56
36. Axa: voluntary health insurance premiums and claims in Ukraine (UAH m), 2008-H1 2010      57
37. Ilichevskoe: voluntary health insurance premiums and claims in Ukraine (UAH m), 2007-H1 2010      58
38. Breakdown of private medical facilities in Russia (%), by form of ownership, 2010       65
39. Revenues (€ m) and change for Medsi Group in Russia, 2009-Q1 2011      70
40. Breakdown of private medical facilities in Ukraine (%), by number of facilities, 2010      77
41. Revenues (€ m) and change for Boris clinic in Ukraine, 2006-2009      82
42. Revenues (€ m) and change for Medychnyi Tsentr Dobrobut in Ukraine, 2006-2009      83
43. Frequency of use of public and private healthcare in Russia, 2011      88
44. Breakdown of private medicine market in Ukraine (%), by number of facilities, March 2010      89
45. Five most corrupt markets in Russia by the total value of bribes (RUB bn), 2010      93
46. Frequency with which Ukrainian patients gave presents to public healthcare professionals, 2010       94
47. Russian population in age groups 0-14 and 65 or over (’000), 1990, 1996, 2001-2010      95
48. Ukrainian population in age groups 0-14 and 65 or over (’000), 1990, 1996, 2001-2010      96
49. Frequency of visits in private healthcare facilities among Novosibirsk residents (%), May 2011      102
50. Factors determining selection of private facility in Yekaterinburg (%), 2007      103
51. Preferred medical facilities by place of residence in Ukraine (%), 2010      103
52. Level of satisfaction with public healthcare among Ukrainian citizens (%), 2001 and 2010      104

List of tables

1. Breakdown of insurance system in Russia in accordance with the official standards of the Federal Service for Insurance Supervision, 2011      12
2. Breakdown of insurance system in Ukraine in accordance with the official standards of the State Committee for Regulation of Financial Services, 2011      13
3. Key trends and events in Russia and Ukraine, until 2011      19
4. Trends and events expected in Russia and Ukraine, 2011-2013      19
5. Breakdown of investments in commercial medicine in Russia (RUB m), 2005-2008      31
6. Differences between MHI and VHI systems in Russia, 2011      38
7. Major players in voluntary health insurance in Russia, by insurance premiums, 2010      50
8. Major players in voluntary health insurance in Ukraine, by insurance premiums (UAH ‘000), H1 2010      59
9. Approximate prices for individual VHI in Russia (RUB), 2011      62
10. Price list of individual medical subscriptions provided by Family Doctor in Russia (RUB), 2011      63
11. Price list of medical insurance policies in Ukraine, 2011      64
12. The number of private hospitals and clinics run by selected important players in Russia, August 2011      66
13. Number of outpatient clinics and visits per shift in Russia (‘000), 2000-2009      67
14. Number of hospitals and hospital beds in Russia, 2000-2009      68
15. Total number of beds in Russia (‘000), by profile of medical unit, 2000-2009      69
16. Other prominent private medical services companies in Russia, 2011      76
17. Number of private hospitals and clinics run by selected important players in Ukraine, August 2011      78
18. Total number of outpatient clinics and visits per shift in Ukraine (‘000), 2000-2010      79
19. Total number of hospitals and beds in Ukraine, 2000-2010      79
20. Other prominent private medical services companies in Ukraine, 2011      85
21. Number of dental facilities in Russia, 1995, 2000, 2005, and 2007-2008      87
22. Number of dental facilities in Ukraine, 1995, 2000, and 2005-2010      88
23. Selected players in the dentistry segment in Russia and Ukraine, 2011      89
24. Selected players in the ophthalmology segment in Russia and Ukraine, 2011      91
25. Number of gynaecological clinics in Ukraine 2000, 2005-2010      92
26. Selected players in the gynaecology segment in Russia and Ukraine, 2011      92
27. Informal payments for selected medical services in Ukraine, 2010      94
28. Life expectancy in Russia and Ukraine, 2000-2009      96
29. Labour market indicators in Russia and Ukraine, 2005-2009      97
30. Gross National Income (GNI) per capita in Russia and Ukraine ($), 2000-2008      97
31. Demonstration prices of selected medical services in different European countries (€), 2008      98
32. Map of medical tourism destinations in Russia and Ukraine, 2011      100
33. Total number of hospital facilities in Russia (’000), 1995, 2000, 2005-2010      100
34. Total number of hospital beds in Russia (’000), 1995, 2000, 2005-2010      100
35. Average length of hospital stay in Russia and Ukraine (number of days), 2000-2010      101
36. Total number of outpatient facilities in Russia and Ukraine (’000), 1995, 2000, 2005-2010      101
37. Productivity of outpatient facilities in Russia and Ukraine (‘000), 1995, 2000, 2005-2010      101
38. Government health spending as % of total health spending in Russia and Ukraine, 2000-2009      106
39. Government health spending as % of total government spending in Russia and Ukraine, 2000-2009      106
40. Total government health spending as % of GDP in Russia and Ukraine, 2000-2009      106
41. Total government health spending per capita in Russia and Ukraine ($), 2000-2009      106
42. Total health spending per capita in Russia and Ukraine ($), 2000-2009      106
43. Social security health spending as % of general government health spending in Russia and Ukraine, 2000-2009      107
44. Private health spending as % of total health spending in Russia and Ukraine, 2000-2009      107
45. Out-of-pocket spending as % of private health spending in Russia and Ukraine, 2000-2009      107
46. Private prepaid plans as % of private health spending in Russia and Ukraine, 2000-2009      108
47. Spending of households on paid medical services in Russia (RUB), by social and economic categories, 2000, 2005-2008      108