Who can crack medicalised homecare?
Praxair’s merger (well, takeover) of Linde will be interesting to watch as Linde is a big medical oxygen at home business in Europe. Healthcare Europa estimate its sales at around €900m in 2015, although some of that will be the supply of oxygen to hospitals. But building a well-spread medical homecare business is not easy. This is the least internationalised of the major sub-sectors in health care services.
Sources who know the sector well, say that Linde has not been particularly active in healthcare. They contrast it to fellow gas giant Air Liquide which has been making various acquisitions in allied areas of care. The aim for both Air Liquide and Advent-owned distributor Mediq is to attempt to build a really holistic medicalised home care business, one which doesn’t just cover, say, oxygen or drug delivery at home, but offers a complete compendium of services, including nutrition and specialised nursing care for every condition.
Neither Air Liquide nor Mediq, which has its roots in distribution, have managed to build such holistic models outside of their respective home markets, France and the Netherlands.
That reflects the regulatory and payor issues which plague the sector. In each country, the rules vary dramatically. Pharmacies stop home drug delivery by third parties in France. In Germany, remuneration is still around the device or consumable, rather than the service, and so on. Big pharma and medtech groups, who would love to build direct to the patient delivery models, are regarded (rightly) by policymakers with deep suspicion.
What all European countries urgently need are “neutral” service operators who can deliver the entire range of medical care services at home tailored to patient needs. In the best of all possible worlds, these players should be able to operate the same models internationally, so they can focus on best practice delivery, rather than wandering through bureaucratic mazes. Sadly, direction of travel here remains slow.
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