Focus on Portuguese healthcare firms

OECD Observer

Interviews of leaders of Portugal healthcare private sector.

Isabel Vaz , Chairman of the Executive Committee of Espírito Santo Saúde - SGPS

What role do you play in the health system in Portugal?

Espírito Santo Saúde aims to be a hallmark in health care seting the highest standards of excellence and innovation in medicine. The Group is fully engaged with this vision, ensuring the best medical diagnosis and treatment that experience, innovation and dedication may allow. Our mission is to diagnose and treat promptly and efficiently, with full respect for the individuality of the patient, and to build an organization able to attract, develop and maintain exceptional people. Placing first patient’s best interests reflects a state of mind, a culture and a mindset of an organization focused on patients, and that strives to merit their preference. At Espírito Santo Saúde it has always been clear that all other goals and skills are instrumental in achieving this, and it is here that our true strength lies.

Since our establishment in 2000, the Group developed an integrated network of hospitals and ambulatory clinics, nursing home units and independent assisted senior living residences. We also participate actively in the Public-Private Healthcare Partnership Program.

Nowadays, the Group holds and manages seven hospitals, seven ambulatory clinics, one nursing home and two independent assisted senior living residences, nationwide. From 2012, Espírito Santo Saúde will also manage a public hospital.

Espírito Santo Saúde units are responsible, yearly, for more than one million consultations, about 35 thousand surgeries and deliveries and almost 3.5 millions diagnostic tests, already earning the confidence of more than one million people. So, a decade on, Espírito Santo Saúde has become an essential reference in the sector and, we believe, has contributed in an outstanding and exemplary way towards the development of private healthcare initiative in Portugal.

How did you leap to the forefront?

Espírito Santo Saúde Group brought innovation to the Portuguese healthcare sector, joining medical knowledge, experience and technology to all the best practises from other economy sectors, namely customer service, information systems and technologies, human resources management and innovative organization models.

This unique model in the Portuguese healthcare sector, offers our professionals all the conditions to practice a differentiated medicine, and to set the highest standards concerning technical, human and service levels of their work, being both efficient, safe and feasible.

What services do you offer your customers?

Espírito Santo Saúde provides a global offer and a comprehensive and integrated approach of health problems, allied to safety, comfort and privacy of patients and their families, ensuring continuity in care and responding to changing health needs over people’s life.

In Espírito Santo Saúde health units you can find a full range of medical and surgical services, with emphasis on differentiated areas supported by state of the art technology.

For example, Hospital da Luz in Lisbon reflects the Group’s ideal for an outstanding health care practice, joining in a single integrated health complex, an acute care hospital and a nursing home.

Hospital da Luz has all medical and surgical specialties, organized in several multidisciplinary centres of excellence – oncology, minimally invasive and robotic surgery, arrhytmology, haemodynamics, obesity treatment, digestive pathology, thyroid pathology, sports medicine, pain management, child neurodevelopment, high risk pregnancy, among others.

What are your plans for the future?

The mission we set 10 years ago is still up to date and more than ever in place. We are focused on talent, high quality medicine and values of integrity, spirit of service and absolute respect for patients.

Accomplishing its mission, the Group will certainly guarantee citizen’s respect and recognition. To deliver the best care to our patients, we will continue working with top health professionals supported by the most innovative equipment and technology. For the next three to four years, concerning future investments in facilities, Hospital da Luz will be expanded and there will be a new unit in Oporto, the second largest Portuguese city. The opening of Hospital Beatriz Ângelo in 2012, the Group’s first public-private partnership, will also be an important milestone for the next few years. International expansion will also be a priority for the upcoming years, specially in markets where we believe our management model can add value.


Rua Carlos Alberto de Mota Pinto,17 – 90

Ed Amoreiras Square, 1070 – 313 Lisboa . Portugal

Tel: 351 213 138 260 Fax: 351 213 530 292

email: -

João Almeida Lopes

Chairman of APIFARMA, Portuguese Association for the Pharmaceutical Industry [Associação Portuguesa da Indústria Farmacêutica]

What is your role in Portugal’s healthcare system?

APIFARMA, the Portuguese Association for the Pharmaceutical Industry [Associação Portuguesa da Indústria Farmacêutica], represents some 140 companies dedicated to the research, production and commercialisation of vaccines, diagnostics and other medical products for human and animal use. As the representative association of Portugal’s pharmaceutical industry, it resolves problems shared by its members and contributes to the socio-economic development of the health sector by providing a wider access to new therapies.

It upholds high ethical and quality standards to fulfil this mission, regarding solidarity and social responsibility as central to its task. APRIFARMA works closely with the government, Parliament, public administration, as well with international bodies and patient associations. It cooperates with professional bodies and other associations in the health sector, with the aim of providing better health care to patients through medical products.

Through its studies and initiatives, APIFARMA also seeks to raise public awareness of the value of medical products and their decisive role in social progress and the improvement of the quality of life.

What services do you offer members?

Services to member companies cover all the multidisciplinary fields relevant to the sector, namely the economic, legal, financial, pharmaceutical and professional training areas. They cover national and international intervention close to European institutions, government bodies and other major players in the medical products sector, as well as partners in the health area. At the legal level, APIFARMA supports associates involved in pharmaceutical legislation, and in corporate, labour, administrative, and ethical issues.

How is the pharmaceutical industry sector in Portugal?

Portugal’s pharmaceutical industry is composed of both national and multinational companies whose activity represents approximately 2.8% of the country’s Gross Domestic Product (GDP). They contribute a significant amount of high-quality employment, providing some 12,000 direct jobs. In recent years, the national industry has made a clear commitment to internationalisation, with growth in export activity registering more than 30% between 2004 and 2009. One result of this growth has been the creation of the PharmaPortugal project, a successful public-private partnership and a pioneering initiative in the pharmaceutical industry. PharmaPortugal involved Portugal’s regulatory authority for medicines and health products, INFARMED, and the investment agency, AICEP, which acts as a platform to disseminate the image of modernity and quality, based on European standards, which are characteristic of Portugal’s pharmaceutical industry.

In terms of investment, a study carried out for APIFARMA by an external consultant showed that during the 3-year period from 2006 to 2008 global investments grew by approximately 28%. The particularity of these investments is that they were channelled into R&D, demonstrating a clear commitment to the development of the sector at the national level. Over the last few years, however, and particularly during the last two, strong constraints in terms of market evolution due to restrictive government measures reduced growth to approximately -05% in 2009.

The sector has also witnessed the development of a number of small biotechnology companies which have progressively promoted partnerships with other companies in the sector.

What is Portugal’s pharmaceutical industry doing with regard to the environment and biodiversity?

Through APIFARMA, the national pharmaceutical industry has joined with other participants in the medical product chain - distributors and pharmacies – to create VALORMED, a company responsible for the management of medical packaging and the waste generated by medical products. Although the medical products sector generates less than 0.5% of urban solid waste, the project is justified in terms of public and environmental health. With its commitment to the treatment of waste and its funding of this activity, the pharmaceutical industry has assumed an important public commitment to do all it can to ensure the safe disposal of used medical packaging, thus contributing to a safer and healthier environment for all.

Dr Francisco Lino, MEDIS Chief Executive Officer

What role do you play in the health system in Portugal?

In 1996, Médis was the first private health insurance company in Portugal to launch the managed care concept, changing forever the local insurance market. More than a health insurance, Médis presents itself as an integrated health care system, where customers get the best medical assistance with excelling service.

Until Médis, the traditional health insurance indemnity plans were the only option for customers and private health was considered a small luxury, leading to few existing private health operators.

Médis success and leadership pushed the rest of the market to turn into managed care and contributed for a double-digit market growth in the last decade. Portugal has now over 2 million people insured.

In fact, this growth in the health insurance market has highly contributed at the same time for the appearance of new and stronger medical providers, such as hospitals and clinics. Nowadays, private medical assistance has become a habit to Portuguese people.

In 2009, despite the economic environment, health insurance grew high above the other lines of business, including compulsory insurance.

We are proud to say, that Médis played a significant role in turning high quality private health services affordable for the mainstream segment.

Nevertheless, in Portugal, private insurance is complementary to the National Health Care System, with customers seeking higher quality assistance through insurance, but with the State Health Care system playing a fundamental role for people with no insurance or when long term care is needed.

The nearby future holds structural challenges for the sector and Médis aims to keep playing a decisive role in the system.

How did you leap to the forefront?

Since day one, innovation and quality are part of Médis DNA.

Médis benefited from being the first to launch managed care and wisely used this advantaged towards competitors, which later were forced to follow this same path. Choosing innovation as a constant lever, Médis kept launching new solutions to meet customers needs; launched the 1st internet health insurance transaction site; provided Linha Médis - a 24h telephone line for medical counseling and supported in a trademark clinical algorithm – still unique within competitors; all of this supported in a recognized excelling service, essential to keep Médis being a step ahead.

Médis brand is also highly perceived in the Portuguese population, being considered 4 times SuperBrand and 2 times Trusted Brand, leading notoriety in health insurance by far. According to a Market Research Survey requested to Nielsen in 2008, Médis was recognized by all stakeholders as a health specialist, with high recommendation and satisfaction indexes highly above its market share.

Another important pillar for Médis success has been its multi-channel distribution strategy. Millennium bcp bank has been always Médis prime distributor, but Médis is also sold by all major agents and brokers and even by four relevant insurance players which preferred to benefit from Médis Health knowledge rather than risking to create an own solution.

Being in the Health business and as an insurance company also means being social responsible.

Médis has recently enlarged its range of actions in different ways that led, for example, to the creation of ‘Médis Prize’ – a financial award to promote science research -, or launching a Médis website for Kids – www. -, where children can have fun learning basic health concepts. In fact in each front, Médis built its way to the forefront every day, faithful to its foundational values, leading to where it stands today.

What services do you offer your customers ?

Médis is an integrated health care system, working in managed care, which implies that we finance our customers expenses, paying directly to our network providers.

All Médis health plans gather core advantages that characterize its value proposition, like for example: access to the Médis providers network with over 6.000 health specialists, including the best private hospitals and clinics; a Personal Médis Primary Care Physician; access to a 2nd opinion from international Best Doctors and preferred conditions with a wellbeing providers network through Médis Card. Médis has a unique International coverage, which allows customers to get treatment worldwide for serious illnesses with 1,000,000 euros capital and exclusive advantages in Clínica Universitária de Navarra with unlimited capital. Besides a 24x7 Medical Counseling Telephone Line, Médis has also materialized its presence in the main hospitals with a dedicated nurses team area – Espaço Médis -, keeping a proximity relationship with clients and providers.

What are your plans for the future?

Médis ended 2009 with 23,9% market share with a consistent growth and profits over the years. Notoriety, stakeholders satisfaction and recommendation benchmark levels provide a solid ground for further growth. Focus areas will be on continuing meeting customers’ expectations by delivering an attractive offer and excelling service, keeping financial and technical solidity – Médis has benchmarks claims ratio -, and explore business opportunities.

These goals are achievable throughout innovation and new technologies, like for example the web, where Médis is focusing efforts in 2010. Starting with a look & feel site refreshment and adding new and more complete transactions to Médis Customers, we increased convenience. In terms of Médis system efficiency, we are improving online interfaces with the providers network and distributors and allow customers to complete all the subscription and buying process online. These are just some examples of ways to continue our path, honoring Médis history and getting ready for the challenges ahead: the more efficient we are, the stronger we become. In this way we aim to fulfill our customers’ needs and match our shareholders return expectations.



Tagus Park, Edifício 10, Piso 0, 2744-002 Porto Salvo

tel: Lisboa - 21 845 8888 / Porto - 22 207 8888

©OECD Observer No 281, October 2010

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