The AdC identifies barriers to the opening of new facilities and proposes recommendations aimed at promoting the well-being of chronic disease patients
The Portuguese Competition Authority – Autoridade da Concorrência (AdC) has undertaken an analysis on the hemodialysis care provision sector in Portugal, where it has identified barriers to the opening of new facilities and a limited patient choice with respect to the facilities where they are treated.
In March 2020, more than 12,000 Portuguese were undergoing hemodialysis, which is the predominant method of dialysis therapy for treating chronic kidney disease. Hemodialysis is mostly provided by private operators – about 93% of patients. The prevalence of chronic kidney disease in Portugal is high compared to other countries and the number of patients undergoing treatment has increased, on average, about 3.5% per year, between 1998 and 2019.
In Portugal, there has been a consolidation of the incumbents’ position in the hemodialysis sector. Barriers to entry and expansion are singled out as a strong limitation to competition by the operators.
Among the barriers to the opening of new facilities, the AdC highlights the significant legal uncertainty in the regime of private contracting of NHS services (i.e. convention regime) and the delays in the convention regime and in the licensing procedure.
Barriers to the opening and expansion of hemodialysis facilities