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The deal with renal patients

The Zurich-based city hospital Waid gets the competition to be felt directly. It has recently taken in Oerlikon, an external station with eight Dialysis sites in operation. The offer is primarily aimed at kidney patients who are young and mobile, and after working for the four-hour blood cleansing in the Andrea storm. In the new building to the East of the station you are in the 14. Floor with beautiful views of the city.

The development prospects of the company, however, are clouded. Because a few months earlier, the DWZ AG has just opened 400 meters of another company located on the South side of the station Oerlikon, a dialysis station with 14 seats. To belong to the company, two dialysis centers in Urdorf and Hochfelden, who were led for many years as a private practice are self-employed, renal specialists. These have sold in the DZW. Or, rather, to B. Braun, a German family-owned company that operates worldwide. It medicine makes technical and pharmaceutical products, including Dialysis machines and fluids for blood purification; in addition, it offers medical services. That B. brown is behind DZW, shows a comparison of the sites; - transparent it is made.

device manufacturer to the service provider

The dialysis division of B. Braun achieved in fiscal 2017 sales of over one billion euros, 9 percent more than in the previous year. There are more products, more services were sold. "Through the acquisition and establishment of new dialysis centers, the Expansion of this business could be driven area," in the annual report.

In Switzerland, the company has begun to. According to the local managing Director Roman Kübler, no further acquisitions are currently in, "but we are open". The global strategy of B. Braun also applied for the Switzerland: "We want to develop from a pure product business to a full-service provider."

The strategy is clear

B. Braun is pursuing the same strategy as the German group Fresenius and his company, Medical Care, the world's largest providers of products and services for kidney patients. Their turnover amounted 2017 to 17.9 billion dollars, the net profit amounted to just under 1.3 billion. The company, which is traded on the stock market, lost it last year, after they had adjusted their profit expectations downwards. Meanwhile, the analysts recommend to buy the stock. One thing is certain: The number of kidney patients is on the rise. The diseases that most often lead to renal failure – Diabetes and hypertension, are increasing worldwide.

There is a conflict of interest when Physicians are employed by the industry.Patrice Ambühl, chief physician Nephrology city hospitals Waid and Triemli

In the U.S., Fresenius Medical Care has been a dominant market position, and also in Germany, the company is strong. In Switzerland your dialysis are widely used devices, but their own dialysis centers it operates only four: in 2018, it has acquired two existing practices in männedorf and Zurich-Altstetten and in münchenstein BL, 2017 in Lucerne, Switzerland. To planned further acquisitions, spokesman for Fresenius to say nothing. According to industry experts, the group is pursuing an active expansion policy and practice, to write to owner directly.

profit optimization as an objective

Patrice Ambühl, Nephrology, chief physician of the city hospitals Waid and Triemli, is watching the development with concern. Not only out of sadness because of the Situation in Oerlikon. He sees a conflict of interest, "when Doctors are employed by the industry and paid for". Industrial owner of a dialysis station wanted to sell only their own products, which limits the freedom of choice of Doctors. To illustrate the problem Ambühl describes an extreme example: "Novartis established a hospital and treated the patients with Novartis drugs."

Also, and this weighs heavier, were in the commercial economic pressure on the Doctors, because profit maximization was their primary goal, says Ambühl. Possible consequences: the patient will not be offered to the dialysis, if a blood purification would still be absolutely necessary. Or, you will be transferred to a hospital, when their care is expensive, because they might suffer of other diseases or be confused. A private practice has no obligation. Specifically, the Ambühl means: "The waid city now has the Problem that the competition can pick up in Oerlikon, the good risks." The Fare is always the same, whether a specialized nurse cares intensively for the kidney patient, or a medical practice employees after him in looks. The economic disadvantage for the public hospital.

That such mechanisms play, is difficult to prove. According to Ambühl's first experience on the Zurich, however, point in this direction. As former employees reported at the end of dialysis stations, which were taken over by B. brown, that the pressure on the staff cost savings is increasing. And patients would find that the presence of Doctors had declined, and less continuity in the care.

foreign shows, where it goes

Christoph choice fields, the former owner of the dialysis centre, with a colleague, together with the kidney specialist had founded the practice in 2004; today, both work as employees of the DZW. Choice, soon to be 61, justified the sale with the following problems. "Not many young nephrologists are willing to work so much." The dialysis is to take place at defined times during the week. But choice for its patients around the clock and also on weekends; he knows you for decades. "Dialysis is the treatment of the chronically ill. You to the hospital to deport, is not for me to question," says choice.

In the dialysis center Hochfelden have changed since the Takeover by B. Braun so far, nothing says choice. He sees the risks, as a result, when a medical product manufacturer, also the treatment. "That the independence of the physician is put to the part in question, white is from Germany."

Both B. Braun, as well as Fresenius write in opinions, that in the assumed centres of the freedom of Therapy are preserved. The Doctors would act according to the guidelines of the nephrological scientific societies. And they are not required, the products of the owner company. B. brown writes: "of Course we welcome it when our centers use our products." And Fresenius points to the benefits of the network: It provides synergies in purchasing, technical maintenance, IT, administration and in the recruitment of professionals. As a result, the nephrologist would be "more time for your patients".


Created: 05.02.2019, 21:45 PM

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