Experts call for action to fight corruption in Croatia's healthcare sector


A recently discovered corruption scheme involves hundreds of doctors and pharmacists.

By Selena Petrovic for Southeast European Times in Zagreb -- 15/01/14


Experts say expensive medications and physicians' low incomes create opportunities for bribery in Croatia's healthcare system. [Gabriel Petrescu/SETimes]

Experts and activists are calling for Croatia to strengthen anti-corruption efforts, especially in its healthcare system.

Croatia's Corruption Perceptions Index is 48 points, below the EU's average score of 62.2, according to Transparency International Croatia.

In a recent case, Croatia's Bureau for Suppression of Corruption and Organised Crime indicted 364 people, many of them reportedly general practice doctors, and generic drugs manufacturer Farmal, for conspiracy to commit crime, bribery, abuse of office and to commit and incite abuse of power.

"Individuals who use public service for personal gain are causing enormous damage to a great majority of doctors who are doing their jobs scrupulously, and, worst of all, they are ruining patients' trust in the health system," the Ministry of Health said in a statement to SETimes.

According to the indictment, published on December 27th, Farmal's CEO Drazen Dedi and four other executives established and ran a network of doctors and pharmacists across Croatia to sell the company's products. In return, doctors allegedly received various gifts, including money and travel, worth 5 to 10 percent of the prescribed medicines. The indictment covers the largest number of accused in Croatia's judicial history.

In the course of the operation, nine Farmal representatives, including Dedi, were detained in November 2012 and were placed in a 30-day investigative custody.

"Sanctioning the offenders is necessary for a successful fight against corruption," Davorka Budimir, Transparency International Croatia president, told SETimes.

Predrag Gavric, a doctor who works in private practice, said corruption related to pharmaceutical companies and their products is a broader issue involving many levels of the healthcare system.

"[Physicians and specialists at the public health centres] are relatively underpaid, which provides a breeding ground for corruption," Gavric told SETimes. "Expensive medication used for treatments [in hospitals and clinics] and a limited number of people who are making decisions about the use of some medication" also are among the conditions that lead to bribery, he said.

Expert bodies within the state institutions are another venue that could "invite" corruption, especially in situations when they decide what drugs to include on the list for the Croatian Institute for Health Insurance (HZZO) or what drugs will get the general approval for use in Croatia, Gavric said.

Pharmaceutical companies are aiming to "enlist" as many physicians at the primary level of medical care as they can to achieve more significant gains, Gavric said. It is difficult for these physicians to finance their participation in medical conventions, which are an important part of the medical license renewal process.

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"Since pharmaceutical companies put aside large sums to sponsor doctors' participation in professional gatherings… this specific connection between doctors and pharmaceutical industry should be put under special scrutiny," Budimir said.

According to the Ministry of Health, the government launched a series of projects in the last two years to prevent corruption. One of these projects is the joint public procurement of medicines, medical materials, electricity, food supplies, and other products and services used daily in the health sector. In addition, the business intelligence system has been introduced to monitor and analyse the prescribing of drugs in primary healthcare.

"The goal is to decrease the corruption threat in procurement and in prescribing of medicines as much as possible," the ministry representative told SETimes.

What are the most efficient measures the government should take to eliminate corruption networks and increase transparency in Croatia's healthcare system? Join the discussion below.

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