Konsulu Suvaziavimui 20120608 EN5 Final Issiustas

LITHUANIA: MEDICAL TOURISM DEVELOPMENT 2012.06.
14
L.PASKEVICIUS, LITHUANIA, VILNIUS
MEDICAL TOURISM IN LITHUANIA

NEW PERSPECTIVE OF ENTERING
HIGH VALUE MARKET OF MEDICAL
SERVICE EXPORT
Laimutis Pakeviius M.D., MBA

President of Lithuanian Medical Tourism Association Medical Lithuania
President of Association of Lithuanian Private Healthcare Institutions
Director of SK Impeks Medical Diagnostic and Treatment Centre
E-mail: laimutis.paskevicius@medcentras.lt
Mob.:+370-698-49757
Vilnius, 13/06/2012
SUBJECTS
I. Medical tourism definition

II. Global medical tourism market
III. Factors stimulating medical
tourism
IV. EU Directive on Application of
Patients Rights in Cross-
Border Healthcare
V. Possibilities for medical tourism
development in Lithuania
2012.06.14 L.Pakeviius 2
L.Pakeviius 1
LITHUANIA: MEDICAL TOURISM DEVELOPMENT 2012.06.14
SUBJECTS

tourism
IV. EU Directive on Application of
Patients Rights in Cross-
Border Healthcare
V. Possibilities for medical
tourism development in
Lithuania
MEDICAL TOURISM: DEFINITIONS,

OCCURRENCE IN CYBERSPACE
Source: http://www.drprem.com
L.Pakeviius 2
MEDICAL TOURISM
MEDICAL TOURISM is persons travelling to

another country having the primary and main
purpose to check up, recover, or strengthen
his/her health, receiving healthcare (medicine,
dentistry, nursing, rehabilitation, medical SPA)
services, and at the same time using other
tourism services as well.
Medical tourism is an economic activity

that creates value by integrating into a whole
products of the healthcare and tourism
industries.
SUBJECTS

tourism
IV. EU Directive on Application
of Patients Rights in
Cross-Border Healthcare
V. Possibilities for medical tourism
development in Lithuania
L.Pakeviius 3
GLOBAL MEDICAL TOURISM

MARKET (1)
ACCORDING TO THE DATA OF DELOITTE:
In 2007, global medical tourism market is

estimated to be around $60 billion
Growth to $100 billion is expected by 2010

____________________________________________________
In 2007, about 750,000 Americans travelled

abroad for medical services
In 2008, 1.5 million of USA residents sought

medical care in other countries Source:
http://www.deloitte.com/us/medic
altourism
This number is estimated to increase up to
9 million by 2012
2012.06.14 L.Pakeviius
7

MARKET (2)
Over 50 world countries have declared
health tourism a priority tourism field
Forecasted annual growth of medical
tourism amounts to ~30-35%
In 2007, >1 million of patients have
travelled abroad for surgery. It is
forecasted that this number will increase
15 times, i.e., up to 15 million until 2017
Source:
http://www.deloitte.com/us/m
In 2007, >47 million US residents were edicaltourism
uninsured; it is forecasted that in 2010,

6 million of them will go abroad to obtain
medical care.
L.Pakeviius 4

MARKET (3)
ACCORDING TO THE DATA OF KMPG:
Over 3 million of patients around the world
annually go to other countries for medical services
Medical tourism global turnover:

In 2010 $79 billion (actual)
In 2012 $100 billion (forecast)
In 2015 $130 billion (forecast)
_________________________________________________________________________________________________
In Hungary, the dental tourism profits reach

over 227 million Euros annually.
Hungary claims that it occupies about 40% of the
international dental tourism market.
_________________________________________________________________________________________________

MARKET (4)
In 2010, 60,000 patients from UK
travelled abroad for medical treatment
1 patient from UK for medical

services abroad spend about
3,000-5,000 (LTL 12,000 20,000)
____________________________________
Those, who travel for medical

treatment, spend on average more
than double the average tourist spend
Source: http://www.doctorinternet.info/news/item/?EntryId82=250044. 2010-10-10
L.Pakeviius 5

MARKET (5)
ASIAN REGION:
In 2010, revenue from 4.3 million

of medical tourists, who went only
to Asia, amounted to $6,7 billion.
In 2012, it is forecasted that

about 5.6 million medical tourists
will travel to Asia, and they will
bring $9.1 billion of revenue.
LITHUANIA - ON MEDICAL
TOURISM WORLD MAPS
L.Pakeviius 6
THE MOST ATTRACTIVE

MEDICAL TOURISM SERVICES
Dentistry services
Plastic-aesthetic and reconstructive surgery
Hip and knee joint replacement surgery
Eye surgery
Renal transplantation
Cardiac surgery
Health check-ups and complex diagnostics
Infertility treatment
SUBJECTS

tourism
Lithuania
L.Pakeviius 7
CRITERIA, WHY PATIENTS TRAVEL

ABROAD FOR MEDICAL TREATMENT
REASONS DRIVING PATIENTS TO RECEIVE MEDICAL

TREATMENT IN ANOTHER EU MEMBER STATE
Flash Eurobarometer on
"Cross-border healthcare in
the EU". #210, 2007
(Source: http://ec.europa.eu/public_opinion/flash/fl_210_en.pdf ).
L.Pakeviius 8
FACTORS STIMULATING
MEDICAL TOURISM
Cost saving (less expensive services)
Services of higher quality and safety
Better accessibility, shorter waiting time
(absence of waiting lists)
Specific and innovative services,
not available in home country
Services that are not reimbursed by
national health insurance
More friendly services that are
oriented to individual patient needs
Source: http://www.scumdoctor.com/medical-tourism/Medical-Tourism-And-Market-Research.html
WAITING LISTS
About 900,000 British people are waiting for
inpatient treatment on the NHS hospitals and
about 50,000 NHS operations are cancelled
each year.
Source: MedicalTourism.com, 2009
Canadians are waiting on average four months

(121 days) before they can receive treatment in
a hospital and this number is increasing
annually.
Source: Esmail N, Hazel M and Walker MA. 2008. Waiting Your
Turn. Hospital Waiting Lists in Canada 2008 Report. Fraser
Institute: Studies in Health Care Policy
L.Pakeviius 9
SUBJECTS

tourism
of Patients Rights in Cross-
Border Healthcare
Lithuania
CROSS-BORDER HEALTH
SERVICES IN EU, 2007 (1)
4% of EU citizens received medical treatment in another EU Member State

over the past 12 months.
L.Pakeviius 10
CROSS-BORDER HEALTH
53% of EU citizens are open to travel to another EU country to

seek medical treatment.
CROSS-BORDER HEALTH
70% of EU residents tend to believe that costs of medical treatment received in another EU
country must be reimbursed for them by national health insurance company of their home country.
L.Pakeviius 11
DIRECTIVE 2011/24/EU OF THE EUROPEAN

PARLIAMENT AND OF THE COUNCIL
Directive 2011/24/EU of the European Parliament and of the
Council of 9 March 2011 On the Application of Patients Rights
in Cross-border Healthcare ( Cross-border Care Directive):
19/01/2011 The Directive was approved by the European

Parliament
28/02/2011 The Directive was approved by the European

Council of Ministers
09/03/2011 Adoption of the Directive
04/04/2011 Publication of the Directive in the EU Official

Journal
24/04/2011 Entry of the Directive into force
25/04/2013 Transposition of the Directive into national law
APPLICATION OF THE DIRECTIVE (1)
THE DIRECTIVE APPLIES to the patients, who decide

to take advantage of cross-border HC
The Directive covers: cross-border HC
services, prescription, medicinal
products and medical devices
The Directive applies to provision of
cross-border HC, regardless of how
it is organized, delivered and financed
The Directive covers healthcare provision
and reimbursement by both :
Public and private healthcare establishments
Public (national) and private health insurance funds
L.Pakeviius 12
APPLICATION OF THE DIRECTIVE (2)
THE DIRECTIVE DOESNT APPLY TO:

services in the field of long-term care the purpose
of which is to support people in need of assistance
in carrying out routine, everyday tasks
allocation of and access to organs
for the purpose of organ transplants
public vaccination programmes against
infectious diseases which are exclusively
aimed at protecting the health of the population on
the territory of a MS
REIMBURSEMENT OF HEATHCARE
SERVICES
Reimbursement of cross-boarder health care
services:
Ambulatory consultations
Investigations (MRT, CT, lab., etc.)
Health check-ups
Day surgery operations
Inpatient care (with/without prior authorization)
Reimbursement of cross-boarder HC
services by National Health Authorities:
on domestic cost level
for HC that corresponds to the benefits provided
for in the patients home country
L.Pakeviius 13
DEMAND FOR CROSS-BORDER

HEALTHCARE
Usually, people use HC services in
their country of residence
Currently the demand for cross-

border HC services amounts for
~1% (10 billion EUR) of
total public sector expenditure on HC
BENEFITS OF THE DIRECTIVE (1)

90% of EU citizens are treated in
their own country, but 50% of
them are willing to travel to
another EU country for healthcare
Many patients from Nordic
countries come to Central
Europe for treatment, because of
long waiting list
Many patients from UK travel to
other EU countries for treatment,
because of long waiting list and
very high prices at home
L.Pakeviius 14
BENEFITS OF THE DIRECTIVE (2)
Surgery is available immediately

Significant cost saving 78%
Gall bladder removal

surgery queue >5 months
Time and cost savings of treatment in Lithuania

Cost saving in Time saving in
Procedure UK price Queue in UK Lithuania price
Lihuania Lihuania
Body MRI scan (spine, elbow, knee etc) 250 > 5 months 180 28% immediate
Lung MRI Scan 330 > 5 months 180 45% immediate
Heart CT scan 415 > 5 months 230 80% immediate
Surgical varicose vein treatment 2,600 > 5 months 550 79% immediate
Gall bladder removal 4,650 > 5 months 1000 78% immediate
Knee arthroscopy surgery 2,400 > 5 months 830 65% immediate
2012.06.14
Haemorrhoids removal surgery 2,100 L.Pakeviius
> 5 months 850 60% 29
immediate
SUBJECTS

tourism
IV. EU Directive on Aplication
Lithuania
L.Pakeviius 15
RECENT MEDICAL TOURISM

DEVELOPMENT IN LITHUANIA (1)
The year 2011 was announced as the
Year of Health Tourism (2011)
Health tourism was included into the list of

Priority Types of Tourism in Lithuania (2011)
Feasibility Study and Recommendations for

Medical Tourism Development and Promotion of
Medical Services Export in Lithuania were
prepared (02/2012)
The first International Conference for Medical

Tourism took place in Vilnius (01/03/2012)
Cooperation Memorandum was signed

between the Ministry of Economy and the
International Medical Tourism Association
(25/10/2011)
RECENT MEDICAL TOURISM

DEVELOPMENT IN LITHUANIA (2)
Lithuanian Medical Tourism
Association Medical Lithuania
has been established (06/03/2012)
Group of the medical institutions

participated in the Medical Tourism
Exhibitions in Barcelona and Moscow
(2011-2012)
Lithuanian Medical Tourism Internet

Portal: www.medtourism.lt has started to
operate (2012)
Lithuanian Medical Tourism Cluster

started to being formed (2012)
L.Pakeviius 16
STRENGTHS OF LITHUANIA: COMPETITIVE

SERVICE PRICES
SERVICE / GERMANY CZECH POLAND TURKEY ISRAEL LITHUANIA
COUNTRY REPUBLIC
Breast 7500 $ 4312 $ 3712 $ 3586 $ 4037 $ 3224 $
augmentation
Liposuction 4499$ 3054 $ 2800 $ 2207 $ 2500 $ 1400 $
Cataract surgery 1973 $ 921 $ 1741 $ 1673 $ 3500 $ 1232 $
Knee joint 11375 $ - 8348 $ 7175 $ - 5691 $

arthroplasty
Knee joint 2625 $ - 912 $ - 3200 $ 1200 $
arthroscopy
Haemorrhoids 3400 $ 2888 $ 1026 $ 1925 $ 2325 $ 1200 $
removal surgery
Varicose veins 3150 $ 3588 $ 751 $ 2100 $ - 720 $
surgery
Dental implantation 3000 $ 1950 $ 973 $ 970 $ 2000 $ 1202 $
Source: www.treatmentabroad.com
LITHUANIAN MEDICAL SERVICES

EXPORT MAP
L.Pakeviius 17
ATTRACTIVENESS OF LITHUANIA
IN THE MEDICAL TOURISM MARKET (1)
Convenient geographical location
European medical standards
Highly-skilled HC specialists
Russian-speaking and
English-speaking medical staff
Personal attention and high level
of service
Accessible and competitive HC
service prices, especially in
comparison with Western countries
ATTRACTIVENESS OF LITHUANIA
IN THE MEDICAL TOURISM MARKET (2)
Wide choice of high quality services
Modern surgery
Quick service rendering absence of waiting lists
Quick health check-up and disease diagnostics
Latest medical technologies
Developed possibilities of rehabilitation after surgery
Possibilities to match medical services with relaxation and

recreation
L.Pakeviius 18
PRIORITY HEALTH IMPROVEMENT

SERVICES FOR MEDICAL TOURISTS
For Eastern markets:

Cardiology and cardiac
surgery
Plastic-aesthetic and
reconstructive surgery
For Eastern and Western

For Western markets: markets:
Health check-ups Hip and knee joint
replacement surgery
Non-invasive diagnostics
Urologic surgery
Dentistry
Medical SPA
LITHUANIAS LEADERS IN THE FIELD OF

MEDICAL SERVICES EXPORT
L.Pakeviius 19
Health check-ups and operative

comprehensive diagnostics
Eye surgery
Orthopaedics - traumatology
Gynaecological surgery
Bariatric surgery
Plastic-aesthetic and reconstructive surgery
Plastic - reconstructive
surgery
Infertility treatment
Gynaecological surgery
Orthopaedics -
traumatology
Urology
General surgery
Rehabilitation
L.Pakeviius 20
Obstetrics and
gynaecology
Infertility diagnostics and
treatment
General surgery
Plastic surgery
Rehabilitation
Abdominal surgery
Diagnostics
Dermatology
Rehabilitation
L.Pakeviius 21
Cardiac surgery
Arrhythmology
Invasive cardiology
Vascular surgery
Traumatology
Periodontology
Dental implantation
Orthodontics
Aesthetic dentistry
Prosthetic dentistry
L.Pakeviius 22
VILNIUS UNIVERSITY HOSPITAL

SANTARIKI KLINIKOS (PUBLIC)
Transplantology
Oncohematology and
oncology
Cardiovascular medicine
Radiology and nuclear
medicine
LITHUANIA HEALTH SCIENCES UNIVERSITY

HOSPITAL KAUNO KLINIKOS (PUBLIC)
Cardiothoracic and
vascular surgery
Neurosurgery
Paediatric surgery
Gynaecology
Oncology
Nephrology
L.Pakeviius 23
Head and neck surgery

Oncology
Neurosurgery
Neurology
Gynaecology
MEDICAL TOURISM PORTAL:

http://www.medtourism.lt
L.Pakeviius 24
LITHUANIAN MEDICAL TOURISM VISION

2022 (BASED ON STUDYS ESTIMATIONS)
LITHUANIA in 2022 :
Attracts 292 thousand of medical tourists
Annual income from medical tourism LTL

284 (realistic) - 500 million (optimistic)
Annual growth of number of medical

tourists arriving in Lithuania is 15 %
Is the fastest growing health tourism

country in the Baltic - Nordic region
PROMOTION MEASURES FOR

MEDICAL TOURISM TO LITHUANIA
Creation of medical tourism cluster
Ensuring and enhancing the quality of
medical and medical spa services
Implementation of changes in the legal
base
Development of physical infrastructure
and competence
Implementation of measuresintegrated
marketing
Development of sales channels and
promotion of cooperation
L.Pakeviius 25
MEDICAL TOURISM DEVELOPMENT IN

LITHUANIA CHALLENGES
Insufficient image of Lithuania as a safe and
high quality medical tourism country in the
international medical tourism market arena
The lack of coordination (GO & NGO) and

unification of Lithuanian medical tourism
promotion in other countries
Peculiarities in obtaining visas for medical

services in Lithuania
Absence of institutions representing

Lithuanian medical tourism abroad
Lack of cooperation between medical

institutions and other medical tourism related
undertakings in Lithuania (MTA value chain)
DIRECT FLIGHTS TO AND FROM

VILNIUS INTERNATIONAL AIRPORT
THE FOLLOWING DIRECT FLIGHTS TO AND FROM VILNIUS INTERNATIONAL AIRPORT:
1.Barcelona (Wizzair, Ryanair) 15. Liverpool (Wizzair)

2.Bergen (Wizzair) 16. London (Ryanair, Wizzair)
3.Bremen (Ryanair) 17. Milan (Ryanair, Wizzair)
4.Brussels (Brussels airlines) 18. Moscow (UTair Aviation)
5.Copenhagen (SAS) 19. Oslo (Norwegian Air Shuttle,
6.Cork (Wizzair) Wizzair)
7.Doncaster (Wizzair) 20. Paris (Wizzair, Ryanair)
8.Dortmund (Wizzair) 21. Prague (Czech Airlines)
9.Dublin (Aer Lingus, Ryanair) 22. Riga (airBaltic)
10.Eindhoven (Wizzair) 23. Rome (Wizzair, Ryanair)
11.Frankfurt (Lufthansa) 24. Stockholm (Estonian airlines)
12.Helsinki (Finnair) 25. Tallinn (airBaltic, Estonian airlines)
13.Karlsruhe (Ryanair) 26. Vienna (Austrian airlines)
14.Kiev (Aerosvit Airlines) 27. Warsaw (LOT Polish airlines)
L.Pakeviius 26
NEEDED SUPPORT FOR DEVELOPMENT OF

MEDICAL TOURISM IN LITHUANIA
Publicize of Medical tourism to Lithuania at LR
Embassies abroad
Planned and resources based marketing campaign
and spread of information in foreign countries
Creation of image of Lithuania as a center of
Medical tourism in Baltic region
Inclusion of Medical tourism into economical
collaboration and promotion plans
Assistance in finding potential business partners
in foreign countries
Organization of business missions on MT,
Lithuanian MT industry presentation in events
Consider possibility to establish Lithuanian cross-
border Medical Services Export Offices in target
regions on PPP basis
Simpler visa for medical reasons issuing process
MAJOR STAKEHOLDERS IN
LITHUANIAN MT DEVELOPMENT
GOVERMENTS
&
HC MINISTRIES,
DEPARTAMENTS
MASS PRIVATE HEALTH

INSURANCE
MEDIA COMPANIES
MAJOR
STAKEHOLDERS
IN MT
DEVELOPMENT
TRAVEL PUBLIC HEALTH

AGENCIES INSURANCE
& COMPANIES (NHS
MT FACILITATORS IN UK)
EMPLOYERS
& PROFESSIONAL
UNIONS
L.Pakeviius 27
POSITIONING OF LITHUANIA IN THE

INTERNATIONAL MT MARKET
Lithuania is a Western country
of professional medical services,
where it is good and comfortable to recover,
and easy to communicate!
LITHUANIA:
High Value services at a Reasonable Price !
THANK YOU FOR YOUR KIND ATTENTION !
L.Pakeviius 28

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LITHUANIA: MEDICAL TOURISM DEVELOPMENT 2012.06.

MEDICAL TOURISM IN LITHUANIA

Laimutis Pakeviius M.D., MBA

I. Medical tourism definition

I. Medical tourism definition

MEDICAL TOURISM: DEFINITIONS,

MEDICAL TOURISM is persons travelling to

Medical tourism is an economic activity

I. Medical tourism definition

GLOBAL MEDICAL TOURISM

In 2007, global medical tourism market is

Growth to $100 billion is expected by 2010

In 2007, about 750,000 Americans travelled

In 2008, 1.5 million of USA residents sought

GLOBAL MEDICAL TOURISM

uninsured; it is forecasted that in 2010,

GLOBAL MEDICAL TOURISM

Medical tourism global turnover:

In Hungary, the dental tourism profits reach

GLOBAL MEDICAL TOURISM

1 patient from UK for medical

Those, who travel for medical

Source: http://www.doctorinternet.info/news/item/?EntryId82=250044. 2010-10-10

GLOBAL MEDICAL TOURISM

In 2010, revenue from 4.3 million

In 2012, it is forecasted that

THE MOST ATTRACTIVE

Plastic-aesthetic and reconstructive surgery

Hip and knee joint replacement surgery

Health check-ups and complex diagnostics

I. Medical tourism definition

CRITERIA, WHY PATIENTS TRAVEL

REASONS DRIVING PATIENTS TO RECEIVE MEDICAL

Canadians are waiting on average four months

I. Medical tourism definition

4% of EU citizens received medical treatment in another EU Member State

53% of EU citizens are open to travel to another EU country to

DIRECTIVE 2011/24/EU OF THE EUROPEAN

19/01/2011 The Directive was approved by the European

28/02/2011 The Directive was approved by the European

09/03/2011 Adoption of the Directive

04/04/2011 Publication of the Directive in the EU Official

24/04/2011 Entry of the Directive into force

25/04/2013 Transposition of the Directive into national law

APPLICATION OF THE DIRECTIVE (1)

THE DIRECTIVE APPLIES to the patients, who decide

APPLICATION OF THE DIRECTIVE (2)

THE DIRECTIVE DOESNT APPLY TO:

DEMAND FOR CROSS-BORDER

Currently the demand for cross-

BENEFITS OF THE DIRECTIVE (1)

BENEFITS OF THE DIRECTIVE (2)

Surgery is available immediately

Gall bladder removal

Time and cost savings of treatment in Lithuania

I. Medical tourism definition

RECENT MEDICAL TOURISM

Health tourism was included into the list of

Feasibility Study and Recommendations for

The first International Conference for Medical

Cooperation Memorandum was signed

RECENT MEDICAL TOURISM

Group of the medical institutions

Lithuanian Medical Tourism Internet