HBI Deals+Insights / News

Private sector penetration of dialysis compared across EMEA

The latest addition to our Intelligence Centre, dialysis, is the only healthcare sector that has been successfully industrialised, internationalised and privatised by over half, across the EMEA markets we look at. There are four global haemodialysis (the bulk of dialysis) service operators, Fresenius Medical Care, B Braun, Diaverum and Davita (in order of geographical reach). But on the third measure, privatisation, the story is a varied one as shown in this week’s infographic.

Many poorer countries or those that suffered most in the post-2008 financial and Eurozone crises have outsourced to the private sector. Of the Euro-countries, Portugal and Spain have gone the furthest at 90-95% of haemodialysis while Greece is at two-thirds. And poorer CEE countries like Russia, Romania, Hungary, Poland and Czechia have also sent all but the most complex patients to private operators.

The richer Nordics, UK, France and Germany have not had the same cost-cutting pressure to outsource, so we see smaller market shares. This is true of northern Italy, while the south, isolated, would sport a shade of red like its southern European neighbours. Germany is an exception with 60% of the market held by independent privately-owned clinics, but we only consider the market held by the global service operators (12/13%), all of whom are active in Europe’s biggest healthcare market.

These numbers are expected to increase marginally in the UK and Germany as the private sector demonstrates cost-efficiency without reneging on quality, and substantially in Saudi Arabia where outsourcing continues.

Nine out of 19 countries in the map have privatisation figures over half. But if you add Saudi’s other private sector providers (the 30% is Davita and Diaverum) and Germany’s independent private sector the agglomerated figure certainly exceeds 50%. Sectors that well exceed this like dentistry, IVF, have not been truly internationalised yet while nursing homes and hospitals, which have to a greater degree, have seen less privatisation (especially with hospitals).

We would welcome your thoughts on this story. Email your views to Cameron Murray or call 0207 183 3779.