Copyright business-review
Romania’s pharmaceutical market is at a pivotal moment, marked by rapid growth and ongoing modernisation. Despite rising investments and a dynamic retail sector, challenges such as underfunding and limited access to innovation persist. Barbara Fritsche, regional director at Servier, spoke to BR about the company’s activity in Romania, its role in the local market, and the key developments shaping the sector. By Anda Sebesi How would you characterise the pharmaceutical sector in Romania? What are the opportunities and challenges you are currently facing here? Romania’s pharmaceutical market is one of the most dynamic in Central and Eastern Europe, with sustained growth in retail sales and a gradual modernisation of the healthcare system, with steps towards digital transformation, investments in infrastructure, and private sector engagement. The market’s expansion has been driven primarily by volume growth and the increasing prevalence of chronic diseases. Although there are initiatives to drive prevention, a well-structured strategy is still pending. Despite progress, Romania’s per-capita health expenditure remains among the lowest in the European Union, which means there is persistent underfunding relative to patient needs. Additionally, several structural constraints limit market efficiency and innovation uptake: reimbursement delays and backlogs, a stringent pricing framework, and a strain on human resources. The Romanian reimbursement system is designed to favour cost control, pricing is set through external reference to the lowest EU prices, while new medicines require a government decision before they get funded. Though there have been improvements in transparency, the pace of listing for innovative products remains slow—particularly in oncology, immunology, and rare diseases. I am acknowledging the government’s efforts in exploring reforms to simplify HTA workflows, improve digital data access, and experiment with value-based agreements, but the progress is slow, hindering Romanian patients’ access to innovation. For my company, which invests heavily in R&D, growth will be dependent on policy reforms and market access acceleration. Without these changes, in my view, Romania risks widening its innovation gap relative to neighbouring EU states. Romania occupies a unique place in Servier’s Central Eastern European strategy: it is both the largest market by population as well as a major contributor to our regional revenues. For a global company like Servier, with more than 70 years of experience in cardiovascular medicine and a recognised leadership role in hypertension, Romania has been—and will remain—a strategic market for scientific investment, medical education, and public-health partnerships. What are some of your ongoing projects in Romania? Servier’s expertise in the cardiovascular space—particularly in hypertension, where we are the global leader—underpins our local footprint. Over the past three decades, Servier has not only introduced and sustained cardiovascular medicines in Romania, but it has invested consistently in professional education, screening, and patient support initiatives. With this heritage, and as the global leader in hypertension care, we believe we have a responsibility to give back to the communities where we operate: to share our knowledge and experience, support patients, and help strengthen healthcare systems. The Romanian market today shows sustained demand for cardiovascular therapies, driven by a rapidly ageing population. Epidemiological research has repeatedly highlighted Romania’s higher-than-average prevalence of hypertension together with gaps in awareness and control—a public-health profile that makes targeted cardiovascular programmes essential. Worldwide, an estimated 1.28 billion adults aged 30-79 have hypertension; 46% of adults with hypertension are unaware that they have the condition; and one out of every patients with hypertension fails to follow treatment correctly. In Romania, in 2023, the standardised mortality rate from cardiovascular diseases was around 600 deaths per 100,000 inhabitants, ranking the country first in the mortality structure by disease classes. Unfortunately, this rate is about 2.5 times higher than the European Union average. Romania has about 6 million hypertensive patients, and over 4 million have high blood pressure values that are not controlled by drug treatment. Of those diagnosed and treated, only about 30% reach controlled blood pressure values. A significant share of people with hypertension do not take any treatment at all, which raises the risk of complications and amplifies the burden on the health system. These data show that, in Romania, adherence to treatment is a weak point; improving it could have drastic effects on hypertension control, reducing mortality and cardiovascular morbidity. We salute the recent approval of the 2025-2030 National Strategy for Combating Cardiovascular and Cerebrovascular Diseases, as it is particularly aimed at prevention, early diagnosis, integrated treatment, and monitoring—and we want to add our full support to this initiative. There are several projects that we have started in Romania as a natural extension of our past efforts, and I believe it is the right time to scale up these investments, considering the poor healthcare indicators mentioned above. A concrete example of this approach is our support in the Mission 70/2030 initiative: an educational and advocacy programme led by the Romanian Cardiology Society and the Romanian Heart Foundation, a National strategic Programme aiming to reduce the burden of hypertension in Romania and improve hypertension control from today’s 30% to 70% by 2030. This project, also supported by various other medical scientific societies, the top 6 medical universities in Romania, the College of Physicians and Pharmacies, patient association groups, and representatives of the Romanian authorities at the highest level, frames an ambitious goal: substantially increasing hypertension detection and control by 2030 through coordinated screening, guideline-driven therapy, and public awareness. We commend the commitment of the Romanian Cardiology Society and the Romanian Heart Foundation to this initiative, and we will offer support along the way, through our dedication and experience from other markets. This type of project can have a huge public health impact over the long term, improving healthcare indicators and patient care and drastically reducing healthcare costs. Based on what we know from international studies, for hypertensive patients, low adherence increases the risk of mortality (all-cause) by around 32%. On the other hand, it was observed that for hypertensives, a 20% increase in medication adherence is associated with a 9% decline in the risk of major cardiovascular events (CVEs), a 16% decline in stroke risk, and a 10% drop in overall mortality risk. While no similar studies have been conducted in Romania—and the results of international research cannot be directly extrapolated—it is clear that achieving the project’s objectives could save several thousand lives each year and, ultimately, generate significant savings for the healthcare system. Opportunities in Romania are clear. First, there is a direct clinical need: improving detection, treatment initiation, and blood-pressure control would reduce morbidity and costs and create demand for modern therapeutic approaches and integrated care models. Second, Romania’s medical community is highly capable and increasingly research-active, and third, digital health and telemonitoring offer a scalable route to improving adherence and follow-up in both urban and rural settings. Our global strategy is focused on accelerating therapeutic progress through digital transformation, and, in the process, transferring and embedding our solutions in every project we support in various countries, including Romania. What do you propose as an approach for the future? Our current Romania plan builds on three pillars: partnerships, scientific impact, and capacity building. Practically, we are partnering with all stakeholders willing to advance the sustainability of the healthcare system and our industry in Romania; supporting education to close the diagnosis-to-control gap; and investing in local projects to document outcomes and health-economic value. Looking ahead, I support a 5-point agenda for my team in Romania, which includes: scaling national support programmes linked to fast-track care pathways; expanding public–private pilots that show how guideline-based therapy and care coordination cut hospitalisations and costs; accelerating transformation towards digital blood pressure monitoring and remote adherence programmes; exploring investment in further local clinical research and tools to generate Romanian data-driven evidence; and working with authorities to design more predictable, value-based reimbursement models that reward outcomes.
