What
makes a difference in Central & Eastern Europe?
Talking about CEE (Central & Eastern Europe) we are talking about
a couple of quite different countries, some of them as large as Poland
with about 38 million inhabitants, some of them with just a few million
people, such as the Baltic states, Slovakia or some of the successors
of the former Yugoslavia. Beside language and history, they differ
especially in their progress from the former system towards Western
Europe and the EU, e.g. in all economy- related issues, but also in
the structure of their health care systems, access to medical care
and treatment habits.
There are significant differences from Western Europe existing in
risk factors across all therapeutic areas and in the application of
preventive medicine. The extent of health-related information available
to patients and the consciousness of a need of self-responsible health
care range on a lower level but may lead to the known closer patient-
doctor relation.
From West to (South-) East, as well as from the capital to the countryside,
there is a steep decrease of the development status in the whole area,
and in each of the particular countries.
Advantages for clinical trials in Central & Eastern Europe are
as follows:
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Medical staff
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Well educated physicians and nurses, high
rate of specialisation in private offices
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Lower grants and wages compared to Western European
countries, applies for all services including CRO’s
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Investigators highly motivated by the opportunity of
achieving a higher standard of living by earning grants
(applies to badly paid state employees in hospitals as
well as to doctors running their private surgeries)
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Investigators interested in international co-operation
and participation in prestigious research projects
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Health care structure and
facilities
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Easy access to all medical standard equipment,
good basic health care
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High-tech equipment, e.g. CT and MRI in major hospitals
only, the number of which is constantly increasing, though
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A centralised health care system still existing (rate
depending on country and indication) allowing fast recruitment
rates. Certain hospital dep. may be responsible for a
population of hundreds of thousands.
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Patients
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Closer patient- doctor relation leading
to a higher compliance and a lower drop-out rate, especially
advantageous in long-term trials
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Depending on indication, pre-treatment schemes and rate
of therapy-naïve patients may differ from Western
Europe
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