07

Sending Patients Across Borders

Medical tourism has been a long-standing practice that emerged due to the necessity of seeking healthcare services outside of one’s country, often due to insufficient local healthcare options. This is frequently associated with an out-of-pocket payment model, where patients cover the treatment costs themselves, limiting access to a small fraction of individuals. In the case of rare medical conditions with limited patient numbers, the question of sending patients across country borders arises, particularly within Europe. Is it worth the effort to establish access in each market, set up treatment centers, and so on? While there are existing pathways to facilitate cross-border treatment, they can be burdensome, require individual patient approvals, and are not intended to handle large patient volumes. While a cross-border model can sound like a great idea on paper, companies should exercise caution when basing their commercial case on a cross-border assumption. If there is a significant number of patients in a given country (the trick here of course is to define ‘significant’) it will be extremely difficult to capture the full potential by having them receive care abroad. Only when the patient number is extremely limited, and/or the procedure requires extremely rare expertise or equipment, does a cross-border model truly make sense. And even in that case, it will be key to work with the health authorities of both the sending and the receiving countries to ensure that the full treatment costs are covered.