The pharmaceutical market in Georgia was highly concentrated, with three major players holding approximately 74% of the market share. After the acquisition of the third and fourth largest pharma companies, GHG became the largest player on the pharma market and is now present in the whole Georgian healthcare ecosystem, maintaining the leading position. Two main competitors in the pharma market are also present in the hospital and medical insurance markets, with much smaller market shares than GHG. GHG therefore remains the only large player across all of these markets as the competitors have not managed so far to establish scalable businesses in the respective sectors.
As of 30 September 2017, c.550,000 voluntary medical insurance packages have been reported to the Insurance State Supervision Service of Georgia. The Georgian insurance market is represented by 14 companies, 11 of which operate in the health insurance segment. The market is highly concentrated, with top three companies holding a c.74% market share by Gross Premium Revenues (“GPR”).
In 2018 our insurance business won two large tenders, retaining the country’s largest insurance client - the Ministry of Internal Affairs (“MIA”) acquiring a significant new corporate client – the Ministry of Defense (“MOD”), as a result the number of GHG’s insured individuals reached c,230,000 in 2019.
In March 2013, the UHC was introduced to address high private healthcare costs in Georgia. The UHC also supplemented and eventually replaced the existing two State Insurance Programmes (“SIPs”), making state-sponsored health coverage available on a significantly larger scale. The UHC is a Government-funded healthcare programme that provides basic healthcare coverage to the entire population, including more than two million people who had never held medical insurance and purchased healthcare services only on an out-of-pocket basis. Unlike the preceding SIPs, the UHC is not an insurance product but an undertaking by the Government to reimburse healthcare providers directly for the delivery of treatment to patients. The programme is subject to certain limits and service and coverage exclusions, beyond which patients have to fund treatment on an out-of-pocket basis or rely on private medical insurance coverage. The key principles of the UHC are as follows:
Pricing, reimbursement and settlement of services under the UHC programme: The actual prices that are charged to patients by healthcare providers are not regulated by the state. However, the reimbursement paid by the SSA to the healthcare providers under the UHC differs depending on the type of service provided and the location of the facility (in some cases reimbursement rates are higher in Tbilisi than in the regions).