2025’s Top Dynamic Healthcare Leaders in Lithuania to Know

1. JANUARY ISSUE 03 2025 2025’s Top Dynamic Healthcare Leaders in Lithuania to Know Rasa Petrikienė Pioneering Dynamic Healthcare in Lithuania with AB “Ortopedijos Technika”

2. “ The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease.

4. Editor’s Note

5. Healthcare Evolution in Lithuania E ntering 2025, Lithuania is facing transformative change in healthcare resulting from innovation and visionary leadership. In our latest edition, ‘2025’s Top Dynamic Healthcare Leaders in Lithuania to Know’ we shine a spotlight on dynamic healthcare leaders who navigate post-pandemic realities while embracing technological advancements to improve the care of patients and healthcare systems. system continues being adaptable, patient- centered, and technologically progressive. We not only honor these exemplary professionals but also look at them as exemplars for future generations of Lithuania healthcare leadership, which demonstrates the real importance of innovative leadership in bringing about a healthier future for Lithuania. The path forward is clear: continued innovation, compassionate care, and strategic excellence will drive Lithuania's healthcare transformation. The sector has to face stringent demands for modernization, efficiency, and accessibility. Featured leaders pioneer solutions through digital health technologies, preventive care strategies, and policy advocacy. Their approach encompasses telemedicine innovations, health data analytics, and mental health awareness, fundamentally redefining patient experiences. These leaders are cooperating across governmental, educational, and private sectors to meet the present needs in healthcare delivery and anticipate future challenges. Their efforts ensure that Lithuania's health Natalie May Natalie May - Natalie May

6. C O N T E N T S CXO 20 Current Role of Pharmacoeconomics in the Context of the Spanish Na?onal Health System Articles 16 Embracing Transforma?on The Effects of Lithuania's Health Reform on Accessibility and Quality 24 Lithuania's Healthcare Ecosystem Exploring Growth Poten?al in Digital Health and Medical Tourism

7. 08 Cover Story Rasa Petrikienė Pioneering Dynamic Healthcare in Lithuania with AB “Ortopedijos Technika”

8. L E A D E R S EUR Health Editor-in-Chief Thanh Truong Managing Editor Pearl Shaw Executive Editor Natalie May Visualiser David King Art & Design Head Samuel Martinez Co-designer Paul Belin Art & Picture Editor Grace Brown Business Development Manager Emily Jones Business Development Executives Anna Smith, Jack Miller Marketing Manager Bill Thompson Sales Executives Mike, Carl, Heidi Technical Consultants David, Robert Assistant Technical Head Joseph Taylor Technical Head Jacob Smile Assistant Digital Marketing Manager Daniel Jones Digital Marketing Manager Alina Sege SME-SMO Executive Gemson Research Analyst Eric Smith Circulation Manager James Carter sales@eurohealthleaders.com January, 2025 Contact Us: Insights Success Media and Technology Pvt. Ltd. Survey No.133/134, Brand Square, Office No. 512, Kunjir Chowk, Pimple Saudagar, Pune, Maharashtra 411027. Phone - India: 7410033802, 8956487823 Email: info@eurohealthleaders.com For Subscription: www.eurohealthleaders.com https://twitter.com/eurohealthleaders Insights Success Media Tech LLC 555 Metro Place North, Suite 100, Dublin, OH 43017, United States Phone - +1614-602-4132 Email: info@eurohealthleaders.com For Subscription: www.eurohealthleaders.com Follow us on : www.facebook.com/eurohealthleaders/ We are also available on : Copyright © 2025 Insights Success Media and Technology Pvt. Ltd., All rights reserved. The content and images used in this magazine should not be reproduced or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior permission from Insights success. Reprint rights remain solely with Insights Success Media and Technology Pvt. Ltd. Euro Health Leaders is powered by Insights Success Media and Technology Pvt. Ltd.

9. 2025’S TOP DYNAMIC HEALTHCARE LEADERS IN LITHUANIA TO KNOW Featuring Person Company Brief Adomas is a visionary entrepreneur specializing in innova?ve solu?ons, driving growth at Ordoline, a pla?orm commi?ed to transforming customer experiences in logis?cs and transporta?on. Adomas Kacinskas Founder & CEO Ordoline ordoline.com Armèle is a passionate innovator behind ARMELE COSMETICS, dedicated to cra?ing high-quality, natural beauty products that enhance individual beauty while promo?ng self-confidence and wellness. ARMELE COSMETICS armele.lt Armèle Tahina Founder & Crea?ve Director Darius is an esteemed healthcare leader at Asmens Sveikatos Klinika, dedicated to advancing pa?ent care through innova?ve treatments and personalized health services in a compassionate environment. Asmens sveikatos klinika asklinika.lt Darius Jonu?s Medical Director Rasa is a transforma?ve leader in Lithuania's healthcare sector, driving innova?on, pa?ent-centered care, and global recogni?on for orthopaedic excellence and accessibility. AB "OrtopedijosTechnika" ortopedija.lt Rasa Petrikiene Chairperson & Medical Director Valteris is dynamic leader at Bal?kameda, focusing on eleva?ng healthcare access and quality by offering a diverse range of medical services and expert consulta?ons. Bal?kameda bal?kameda.lt Valteris Kliukas Managing Director

10. Rasa Petrikienė Chairperson / Medical Director AB “Ortopedijos Technika” In Lithuania, basketball is practically a second religion, so one can only imagine the high standards of the clinics that cater to elite athletes.

11. Cover Story Rasa Petrikienė Pioneering Dynamic Healthcare in Lithuania with AB “Ortopedijos Technika”

12. Plastic Surgeon Karolis Černauskis Our mission is to exceed the expectations and individual needs of the modern patient.

13. 2025’s Top Dynamic Healthcare Leaders in Lithuania to Know Mrs. R. Petrikienė’s journey from a young manager to a visionary leader reflects her commitment to innovation, quality, and compassionate care. In her early career with the company she quickly climbed the ranks, bringing transformative growth to the company’s orthopaedics division. But it was her next step—establishing a cutting- edge medical clinic—that has truly distinguished her leadership. Today, AB “Ortopedijos Technika” employs over 600 professionals and serves tens of thousands of patients annually, with state-of-the-art facilities that include that include specialized centers for surgery, rehabilitation, diagnostics, aesthetics, and consultations. Now in its 80th year, AB “Ortopedijos Technika,” along with Gijos Klinikos, embodies a legacy of excellence and resilience. Under Mrs. R. Petrikienė’s guidance, the company has expanded its services, established itself as a top orthopaedics clinic in the Baltic region, and gained recognition in prominent media outlets like The Guardian, The Sun, and ITV News. From advanced telemedicine solutions to revolutionary surgical techniques, her leadership has cultivated a thriving environment where patient care, innovation, and global standards intersect seamlessly. Plastic Surgeon Mantas Sakalauskas Let’s explore how Mrs. R. Petrikienė is reshaping Lithuanian healthcare, bringing world-class care and innovation to patients globally! A Transformative Career in Healthcare Leadership Reflecting on her career, Mrs. R. Petrikienė says, “Staying with one company for 20 years might seem like a lifetime to today’s generation. But in reality, my career only accounts for a quarter of the company’s lifespan, as in 2025, AB “Ortopedijos Technika” will celebrate its 80th anniversary, and our medical services will mark its 50th anniversary.” Graduating in Business Management and Marketing in 2004, she began working with AB “Ortopedijos Technika” as a manager in its orthopaedics division. Her keen understanding of market needs and her ability to foster a reliable team brought steady growth to the business, laying the foundation for her leadership roles. In time, she was entrusted with the ambitious task of developing the company’s medical services, leading to the inception of Gijos Klinikos—a clinic designed, as she puts it, “to offer the level of care I’d expect as a patient.” I n recent years, Lithuania has established itself as a center for advanced healthcare, attracting patients globally with its high-quality medical services, reduced waiting times, and affordable prices. This reputation is strengthened by a group of healthcare leaders who have merged their professional skills with a focus on patient-centered care. Rasa Petrikienė, the Chairperson of AB “Ortopedijos Technika” and Medical Director at Klinikos, is a prominent figure in this transition, aiding in positioning Lithuania as a hub for high-quality, accessible healthcare. With more than twenty years of committed experience in the orthopaedic field, Mrs. R. Petrikienė has been instrumental in the evolution of AB “Ortopedijos Technika” and its clinic, Gijos Klinikos, which has received global recognition as a leading site for orthopaedic and reconstructive procedures. Gijos Building Success through Vision and Innovation The success of the company is rooted in a commitment to innovation and an openness to adapting new technologies.

14. Staying with one company for 20 years might seem like a lifetime to today’s generation. But in reality, my career only accounts for a quarter of the company’s lifespan, as in 2025, AB “Ortopedijos Technika” will celebrate its 80th anniversary, and our medical services will mark its 50th anniversary. “Following Lithuania’s independence, we could finally unleash our potential,” says Mrs. R. Petrikienė, referring to the major strides her company and the healthcare sector in Lithuania have made since joining NATO, the EU, and other international organizations. This forward-looking approach has enabled the company to keep pace with the latest advancements in both manufacturing and medicine. From the installation of teleradiology systems to the use of AI solutions, innovative, less invasive technologies, modern equipment, Gijos Klinikos remains at the forefront of medical technology. athletes or everyday individuals. The clinic has long- standing partnerships with sports organizations, including the Lithuanian Basketball Federation and Kaunas “Žalgiris” basketball team. According to Mrs. R. Petrikienė, “In Lithuania, basketball is practically a second religion,” which speaks volumes about the trust these organizations place in Gijos Klinikos to care for their athletes. During major events, such as the Turkish Airlines EuroLeague Final Four in 2023 and the FIFA Futsal World Cup in 2021, Gijos Klinikos provided medical support to international athletes. “There is no separate wing for the biggest sports stars,” she explains, “Patients receive the same care, from the same specialists, using the same state- of-the-art equipment.” A Mission Centered on Patient Care Mrs. R. Petrikienė has always emphasized the importance of patient-centered care. “Our mission is to exceed the expectations and individual needs of the modern patient,” she states, explaining that her clinic aims to provide every individual with constant care and support. A unique aspect of Gijos Klinikos is its commitment to offering the same level of care to all patients, whether they are professional Trends in Lithuanian Healthcare Mrs. R. Petrikienė observes that Lithuanian healthcare has evolved significantly in recent years, especially in terms of patient experience. “Both the public and private sectors are

15. becoming increasingly patient-centered,” she notes. In the private sector, this shift is fueled by an increased demand for services, driven by an expanding range of offerings, technological advancements, and a heightened emphasis on staff training. The integration of minimally invasive surgeries, AI, and regenerative medicine approaches, such as cell therapy and biological healing mechanisms reflects a global trend that is gradually reshaping healthcare in Lithuania. Patients benefit from enhanced comfort and convenience, with multiple services consolidated under one roof. world-class care without the long waits they face at home. Media coverage during this time highlighted the growing demand for Lithuanian healthcare, further cementing its reputation as a leader in the field. By addressing a global need for accessible, high-quality surgery, AB “Ortopedijos Technika” and its medical tourism branch continue to make a profound difference in patients’ lives. “Helping people regain their health and confidence is the most rewarding part of what we do,” Mrs. R. Petrikienė added. Medical Tourism and the Global Patient Community Integrating Innovation into Healthcare Delivery For years, Wellness Travels by Gijos Klinikos has been a trusted name in medical tourism, and the pandemic only emphasized its importance. While many countries faced long delays for vital procedures, such as hip and knee replacements, Lithuania provided patients with fast, affordable, and high-quality care. Innovation is not a mere term at AB “Ortopedijos Technika”—it is embedded in the clinic’s daily practices. “Innovation has become part of our daily routine to the extent that it no longer stands out,” remarks Mrs. R. Petrikienė. The clinic has assembled a team of highly skilled surgeons who continuously introduce innovative procedures, such as teleradiology-enabled surgeries and complex joint-sparing orthopaedic techniques. In 2018, Gijos Klinikos performed a groundbreaking shoulder joint operation using a biological implant, followed by Europe’s first aesthetic gastric sleeve surgery in 2021. The clinic offers a seamless experience from start to finish. Each patient is assigned a personal manager to handle all logistics, from airport pick-ups to post-surgery care. “Our goal is to make sure patients don’t have to worry about anything,” shared Mrs. R. Petrikienė. “They can focus on their health while we take care of the rest.” The clinic’s advanced surgical methods include minimally invasive techniques and regenerative medicine approaches, such as cell therapy and biological healing mechanisms. “Our beginnings in 1945 were in orthopaedic manufacturing,” she says, noting the clinic’s evolution to offer computer-controlled thigh prosthetics, bionic hand Lithuania’s strategic location, just a short flight from major European cities, and its adherence to EU healthcare standards make it an ideal destination for medical tourism. By 2023, the country had become a hub for patients seeking

16. prosthetics, and custom orthoses using cutting-edge 3D technologies. AB “Ortopedijos Technika”'s collaborations with global leaders like OttoBock have solidified its position as the largest orthopaedic company in the Baltic region. moved on from COVID-19. Yet, in January of that year, the company was visited by foreign media preparing documentaries and articles about the influx of international patients coming to Lithuania for surgery. It turned out that not all countries had managed the COVID-19 crisis at the same pace. Challenges in Healthcare and How to Overcome Them “Our company’s medical tourism agency, Wellness Travels by Gijos Klinikos, has been operating internationally for over 10 years,” she highlights. Lithuania has long been a popular destination for plastic, orthopaedic, bariatric, and other surgeries. The country’s central location in Europe makes it easily accessible from various countries—for example, a flight from the UK takes just 2.5 hours. The clinic is conveniently located: 100 km from Vilnius Airport and only a 15-minute drive from Kaunas Airport. In healthcare, every day brings unique challenges, and surgical care is no exception. The COVID-19 pandemic tested the resilience of AB “Ortopedijos Technika” like never before. At first, there was a sense of uncertainty and helplessness. However, there were also some truly uplifting moments during that period. One of their doctors suggested offering free remote consultations, and this idea quickly went viral, as every single one of the medical professionals joined in. “Our physiotherapists led exercise sessions from their homes. Such situations remind us of the true meaning of upholding the Hippocratic Oath. It reaffirmed my belief that we have an exceptional team, always ready to help those in need,” shares Mrs. R. Petrikienė. In Lithuania, patients avoid long waiting lists and receive world-class medical care that adheres to global standards. The fact that its healthcare is regulated by EU standards provides an additional sense of security. From the initial enquiry, each patient is assigned a personal manager who oversees their journey. The patient is met at the airport and transported to the clinic or hotel. They don’t need to worry about a thing—just calmly wait for their procedure. The period following the pandemic was even more surprising. By 2023, it seemed as though Lithuania had The pandemic reminded us of the true meaning of what we do, it was heartwarming to see everyone step up so selessly during such a difcult time. Orthopaedic surgeon Gintautas Pocius

17. In many countries, patients face years-long waits for life- changing surgeries, particularly hip or knee replacements. “It’s heartbreaking. The fact that we can offer these procedures quickly, professionally, and affordably has moved not only our patients but also us as a team,” says Mrs. R. Petrikienė. says Mrs. R. Petrikienė, underscoring her focus on fostering a supportive, cohesive work environment. Strategic Vision for the Future Looking ahead, AB “Ortopedijos Technika” aims to expand its reach in Wellness Travels by Gijos Klinikos maintaining its leadership in orthopaedics. Gijos Klinikos’s unique rehabilitation team, which Mrs. R. Petrikienė describes as a major asset, enables international patients to recover efficiently within a short time frame. “We receive astonished praise from foreign medical professionals,” she shares, recounting cases where patients are able to travel home after just 7-9 days of rehabilitation. while The team at AB “Ortopedijos Technika” is eager to raise awareness about this opportunity and is committed to helping as many patients as possible. They are already collaborating with partners in several countries and remain open to establishing new partnerships. Leadership Style and Team Values As a leader, Mrs. R. Petrikienė practices a consultative yet decisive approach. “I always listen to what my colleagues have to say,” she explains, emphasizing the importance of collaboration in decision-making. However, she acknowledges that the final responsibility rests with her, particularly for larger projects and innovative initiatives. “I trust my team and grant them certain freedoms,” she notes, but when it comes to high-stakes decisions, she shoulders the responsibility so her team can confidently move forward. In the coming years, AB “Ortopedijos Technika” plans to enhance its medical tourism agency, introduce a health insurance program, and expand its international network. “Our goal is to offer outstanding medical care for patients around the world, with no waiting list and minimal logistical hassle,” Mrs. R. Petrikienė states, reiterating her vision for a future where healthcare is accessible, reliable, and patient-centered. The rehabilitation needs more emphasis, because it’s unique, done under the same roof as other private clinics can’t offer. Final Thoughts This collaborative approach has fostered a culture of openness and innovation. “The qualities I value most in my employees are dedication, honesty, openness, and courage,” Mrs. R. Petrikienė’s journey with the whole company and Gijos Klinikos as well as Wellness Travels by Gijos Klinikos exemplifies the transformative impact of visionary leadership in healthcare. By prioritizing patient care, embracing innovation, and fostering a culture of collaboration, she has not only elevated her clinic to global prominence but also inspired a new generation of healthcare professionals to pursue excellence. In her words, “The biggest reward for our work is knowing that we have made a difference in someone’s life,” capturing the essence of her mission to create a world where exceptional healthcare is within everyone’s reach. For further inquiries, please visit contact at info@wellness-travels.com. Wellness Travels or For information regarding orthopaedic services and partnerships, please check email at info@ortopedic-pro.com. Orthopaedic Pro or reach out via

18. The E?ects of Lithuania's Health Reform on Accessibility and Quality January 2025 16 www.eurohealthleaders.com

19. Embracing Transformation ver the last few years, Lithuania has embarked on O expanding access and better health outcomes. This change has been made as part of a general process to switch from the Soviet model to a new, more civilized, patient-oriented model. Drawing on work developed within the field of health policy analysis, this article looks into the conse- quences of the Lithuanian health reform initiative, with a special attention paid to the impact of the health reform on the access and the quality of the health services. ambitious reforms in its health care system with the overall goal of increasing the quality of care, Health Reform in Lithuania Lithuania is a small Baltic nation with the constant population of 2,8 million people. Lithuania independence occurred at the end of 1990 and yet the reforms searches for new ways in the HC system had started earlier. Previously the system suffered from inefficiency and underfunding and gave preference to those forms of care which were mostly related to hospitals rather than being related to prevention and primary. Other, including chronic diseases, an ageing population and the health problems of the people were other cardinal reasons for the reform. Starting from 2016, Lithuanian government has set a series of health reforms into motion. This included; Legal changes; Infrastructure development to promote health care; and De-centralization of health care delivery system to enhance institutional-based health care. The main goal was to increase the health care for all people regardless of their social class, place of living and quality of the health care provided. Increasing Accessibility Accessibility in healthcare is important to make sure that the citizens receive necessary services without significant barriers. Lithuanian health reform aimed at addressing different aspects of accessibility: 1. Geographic Accessibility Large parts of the old system in Lithuania were character- ized by health facilities whose access was not equitable. Rural settings lacked enough medical services, forcing many patients to travel long distances for their health care. The reform strategy would entail opening more health centers in the regions which had a low representation, enhancing the transport linkages, and making telemedicine available to an increased population. Consequently, travel January 2025 www.eurohealthleaders.com 17

20. time for patients has reduced over time, increasing access to health care. knowledge and skills, the quality of care delivered to patients has markedly improved. 2. Financial Accessibility 3. Quality Standards and Patient Safety Measures Intro- duced For a long time, the lack of finance has been the primary cause of restricted access to health care in Lithuania. The changes that have been implemented have seen financial protection for the patient improve through the introduction of universal health insurance. This system is meant to reduce out-of-pocket expenditure for basic services, hence reducing health care costs for all citizens. Patients thus receive medical care when needed, hence early diagnosis and better health status. To improve the quality of care, Lithuanian emulated international quality standards and patient safety measures. Standardized protocols for all medical procedures imple- mented have also brought about more consistent treatment outcomes. Patient feedback mechanisms have also been put in place to ensure health care services undergo changes based on the current needs and experiences of the beneficia- ries. Challenges Ahead 3. Time to Deliver Service In dealing with waiting time, which has been highly significant in the past system, reforms streamlined hospital and primary care clinics' procedures. With the adoption of electronic health records and online appointment booking systems, it is now possible to access the right consultation and treatment at the right time. As such, these bottlenecks that previously had plagued the system have significantly improved. Despite the efforts put into reform, Lithuania is still facing significant challenges in health care reform. Budgetary limitations and political turbulence do not make for sustained investments in health care services. Another area of continued challenge is raising full public awareness about the reforms and ensuring fair and equitable distribu- tion among different sections of the population. Conclusion Conclusion of Improving Quality of Care Lithuania's health reform is an important step toward making healthcare more balanced and efficient. This means that the government will focus on enhancing accessibility and improving the quality of care so that every citizen has the chance to access the necessary medical services, thus forming a healthier society. As Lithuania continues embracing transformation, the commitment to refining healthcare will not only benefit the present generation but lay a strong foundation for the health of future generations. The journey of reform is ongoing and will depend entirely on the active participation of government, healthcare providers, and patients to ultimately attain the final ends of health equity and improved outcomes for all. While making health care accessible is of great importance, equally important is ensuring that the quality of the services provided is at a good standard. In the health reform process in Lithuania, several aspects were improved to raise quality: 1. Primary Healthcare Strengthening A core reform has been enhancing primary healthcare service delivery. Prevention and early interventions have been used by the government to shift its focus from simply treating illnesses toward better population health. This also means better control of chronic diseases such as diabetes and hypertension and a reduced strain on secondary and tertiary healthcare settings. 2. Training and Development for Health Professionals - Pearl Shaw Significant inputs were also placed on the upgrading of healthcare professionals' skills. Increase investments have been made in continuing education and training for nurses, doctors, and other healthcare workers. Thus, when healthcare professionals are equipped with the latest January 2025 18 www.eurohealthleaders.com

22. Carlos Rubio-Terrés, MHE, MPharmacol, Bsc Darío Rubio-Rodríguez, MHE, Bcom January 2025 20 www.eurohealthleaders.com

23. Pharmacoeconomics National Health System I n the 1980s, the first economic evaluation studies in the Spanish healthcare field were published . Since then, numerous pharmacoeconomic analyses have been conducted and published in Spain. A simple search in PubMed, using the terms “Cost-effectiveness” and “Spain”, yields (January 13, 2025) 3,544 references. As is often the case with new techniques, the first hurdle that had to be overcome at national and international level was the need to standardize pharmacoeconomic studies. In this regard, several guidelines have been published in Spain over the years, including the Economic Evaluation for Clinicians 2 series and various unofficial guidelines that represented a considerable advance in this regard, one of which was 3 published in 2010 . The first official Spanish guide was developed in the Catalonia region in 2014 . products in the National Health System is one of the great current challenges. Austerity in public spending, essential at all times, has become an urgent objective. Therefore, it is necessary, more than ever, that financing decisions be governed by the criteria of scientific evidence of cost- effectiveness and by economic evaluation, with consideration of the budgetary impact, in which a price scheme associated with the real value that the medicine or health product contributes to the system is taken into 5 account” . This was the first legal text that made official the need for economic analysis of medicines in Spain, despite the fact that this need was tacitly accepted since the 1980s. 1 Recently, the Spanish Ministry of Health has published two draft Royal Decrees: one on the financing and pricing of 6 medicines and another on the assessment of health 7 technologies , both currently in prior public consultation. It also published a proposal for a guide to the economic 8 evaluation of medicines . 4 After this brief historical review of the economic analysis of medicines in Spain, we should ask ourselves what the role of such analyses should be in the general context of the evaluation of medicines. The effects of medicines on the health of patients can be measured by three basic parameters: efficacy (demonstrated by randomized clinical trials), effectiveness in clinical practice (which should be demonstrated by pragmatic clinical trials, rather than by observational or “real-life” studies, which are very common today) and, finally, the efficiency of the new medicine, analyzed by economic studies, mainly cost-effectiveness or cost-utility. In this sense, economic analyses should be considered not only as a necessary step in obtaining the price and reimbursement of the new medicine, but also and above all, as the last stage in the development of a new drug. In order for the doctor to be able to choose the most appropriate treatment, he needs to have not only the efficacy and safety data, but also to know the efficiency of the various treatment options. The proposed guideline includes what has been indicated in previously published guides. However, it insists on considering cost-utility analyses (cost per Quality-adjusted life-years [QALY] gained) to be preferable to cost- effectiveness analyses (cost per Life-years [LY] gained). This approach would be questionable in practice, given that in many cases there are no utility studies carried out in Spain, so that those carried out in other European countries with a similar socioeconomic level must be used. This preference for cost-utility studies could, however, result in more utility studies being carried out in Spain, which would be very positive. In any case, we consider that both results (cost per QALY or LY gained) are equally important when determining the efficiency of a new drug, so the most appropriate thing would be - whenever possible - to estimate both in pharmacoeconomic analyses. 8 According to Royal Decree-Law 16/2012, of April 20, on urgent measures to ensure the sustainability of the National Health System: “The financing of medicines and health Another debatable aspect of the proposed guideline would be the one related to the performance of probabilistic sensitivity analyses. 8 January 2025 www.eurohealthleaders.com 21

24. This is an issue that, surprisingly, has been dragging on since the beginning of pharmacoeconomic evaluation. The probabilistic analysis (generally performed by means of a second-order Monte Carlo simulation) should not be a sensitivity analysis but the base case of the economic evaluation, since it provides a mean result, a 95% confidence interval of that mean and the probability that the most effective drug is cost-effective compared to the least effective, according to a willingness to pay per QALY or LY gained. In our opinion, the base case should be probabilistic, so that uncertainty can be adequately assessed, and univariate sensitivity analyses should be performed (using tornado diagrams) to establish which variables condition the result. URL: h?ps://www.sanidad.gob.es/norma?va/audiencia/do cs/DG_54_24_Solicitud_informacion_publica_RD_EV ALUACION_TECNOLOGIAS_SANITARIAS.pdf (access: 14/01/2025). Comité Asesor para la Financiación de la prestación Farmacéutica del SNS. Guía de Evaluación Económica de Medicamentos. Ministerio de Sanidad, 2023. Available at URL: h?ps://www.sanidad.gob.es/areas/farmacia/comites Adscritos/prestacionFarmaceu?ca/docs/20240227_C APF_Guia_EE_defini?va.pdf (access: 14/01/2025). • References: • Badia X. La evaluación económica en el sector sanitario: revisión de los estudios españoles y apuntes para el futuro. Revisiones en salud pública. 1991; 2: 107-17. Prieto L, Sacristán JA, Antoñanzas F, Rubio-Terrés C, Pinto JL, Rovira J, por el Grupo ECOMED. Análisis coste-efectividad en la evaluación económica de intervenciones sanitarias. Medicina Clínica 2004; 122: 505-10. López J, Oliva J, Antoñanzas F, García-Altés A, Gisbert R, Mar J, et al. Propuesta de guía para la evaluación económica aplicada a las tecnologías sanitarias. Gac Sanit. 2010; 24: 154–70. Puig-Junoy J, Oliva-Moreno J, Trapero-Bertrán M, Abellán-Perpiñán JM, Brosa-Riestra M y Servei Català de la Salut (CatSalut). Guía y recomendaciones para la realización y presentación de evaluaciones económicas y análisis de impacto presupuestario de medicamentos en el ámbito del CatSalut. Generalitat de Catalunya. Departament de Salut. Servei Català de la Salut: Barcelona, 2014. Real Decreto-ley 16/2012, de 20 de abril, de medidas urgentes para garantizar la sostenibilidad del Sistema Nacional de Salud y mejorar la calidad y seguridad de sus prestaciones. BOE Nº 98, de 24 de abril de 2012. Proyecto de Real Decreto por el que se regulan los procedimientos de financiación y precio de los medicamentos. Available at URL: chrome- extension://efaidnbmnnnibpcajpcglclefindmkaj/https:// www.sanidad.gob.es/gl/normativa/docs/CPP_RD_PR ECIO_MED.pdf (access: 14/01/2025). Proyecto de Real Decreto por el que se regula la evaluación de tecnologías sanitarias. Available at Carlos Rubio-Terrés, MHE, MPharmacol, BSc • Carlos Rubio Terrés is Director of HEALTH VALUE, Health Economics & Research of Outcomes Consulting, in Madrid, Spain. Over the past three decades he has held various positions in the Instituto de Salud Carlos III (Madrid), the Ministry of Health (Madrid), the Committee for Proprietary Medicinal Products (CPMP), (Brussels), and in a number of pharmaceutical companies (Lederle, Wyeth, Aventis). He has published 289 articles in peer- reviewed journals and book chapters. • • Darío Rubio-Rodríguez, MHE, BCom • Darío Rubio Rodríguez is a Senior Consultant on Market Access and Pharmacoeconomics at Omakase Consulting SL, in Madrid. Previously he was a Senior Consultant on Pharmacoeconomics at Health Value SL, in Madrid. He has published 84 articles in peer-reviewed journals. • • January 2025 22 www.eurohealthleaders.com

26. Lithuania's Healthcare Ecosystem Exploring Growth Potential in Digital Health and Medical Tourism January 2025 24 www.eurohealthleaders.com

27. L ithuania, as a Baltic country, is known for its long history and cultural vitality. This nation is also turning out to be one of the notable players in the healthcare sector. The country has gained much over the last decade with regard to the modernization of its healthcare infrastructure, with specific focus on digital health and medical tourism. This article takes into account the present scenario of Lithuania's healthcare ecosystem, highlighting potential growth in these two pivotal areas. Current Scenario Lithuania is one of the leading nations in the European region towards a revolution of digital health. The country has embraced different eHealth projects such as E-Health Records, Telemedicine systems and m-Health applications targeting patient and care quality. National Health Informa- tion Centre establishment is an example proving that Lithuania aims at creating a digital health environment that fosters data exchange among laboratories and providers. Growth Potential Increased Adoption of Telemedicine: The use of telemedicine services also increased rapidly all over the world including Lithuania when the Covid-19 pandemic started. The population is connected with internet, and population has easy access to technology making the possibility of telemedicine to become one of the most important parts of healthcare delivery very high. This means that future investment in tele health services could go along way in increasing the numbers of specialist particularly at the rural level which widely lacks specialist. Health Apps and Wearable Devices: The practice of health management through applications and wearable devices is ongoing. Lithuanian startups are creating digital tools that put the power back into patient’s hands helping with tracking chronic illnesses, taking medica- tions, and making lifestyle choices. Data Analytics and AI: The use of big data analytics in conjunction with AI will transform the scenario of the Ÿ Ÿ Ÿ January 2025 www.eurohealthleaders.com 25

28. Challenges and Considerations health sector patient’s care. Having a very strong IT industry in Lithuania places it in the perfect position to create health care solutions with the use of Artificial Intelligence. It may enhance the accuracy of the diagnosis, prognosis of the patient, and enhance the pathway for treatment delivery and thus trying to offer the best health care. It is crucial to understand that there are certain obstacles which lie in the way of digital health as well as of medical tourism in Lithuania despite the fact that both represent growth opportunities. Regulatory Framework: This makes it mandatory for there to be strong regulatory frameworks in place because they are several new developments in the digital health technologies. Lithuania needs to maintain the progress and improvement of its rules as well as prepare the special regulations for highly developing technologies. Competition in the market: This global medical tourism industry is quite competitive. In such a situation, Lithuania must emphasize its specific products and must guarantee that their standard of health care is in international norms to draw in more patients. Public Awareness and Education: Promoting Lithuania as a medical tourism destination and educating potential patients about the services offered is important for growth. Coordination between health care providers, tourism boards, and marketing agencies will increase visibility and attract a larger audience. Ÿ Medical Tourism: Emerging Destination It is one among the fastest growing sectors in the entire world; patients are now seeking medical attention from other nations than their home country. Medical tourism in Lithuania is picking up and currently receives patients from its neighboring countries such as Sweden, Norway, and the UK. Lithuania has state of the art health care centres and well trained staff to attend the patients and to lure the patients for their treatment the charges are very reasonable. Ÿ Major Influencing Factors in Lithuania Medical Tourism Ÿ Quality and Affordability: I could find every type of medical services starting from beauty enhancement surgeries and dental treatments to complicated surgeries such as orthopedic surgery and reproductive health treatments in Lithuania. They can get a treatment in a country at a considerably lower price as compared to the developed countries of Western Europe or the United States, but with equal effectiveness. Most of Lithuanian healthcare providers are globally recognized to guaran- tee the provision of quality health services. Thorough care packages Most Lithuanian hospitals and clinics provide international patients with full service packages, which include all the treatment requirements, accommodation, transport, and aftercare. Thus, these more thorough packages make the medical tourist's life easier and increase their comfort level. Cultural and Touristic Attractions: Apart from medicine, a diverse cultural experience combined with panoramic vistas makes Lithuanian hospitals popular among tourists for medical needs. Patients may exploit the occasion by visiting both old cities in which they come- in, touring and visiting landmarks within the attractive Nature Reserves added to them tourism dimension along the way. Ÿ Conclusion Lithuanian healthcare stands at the entrance to a transformative growth that will be led by advances in digital health and the growth of the medical tourism sector. With a commitment to innovation, quality care, and an attractive cultural landscape, Lithuania is poised to become one of the best countries for patients who are interested in state-of-the-art solutions in healthcare. As the country pushes through its difficult times, there is an open opportunity to see better health care outcomes among citizens and a rising position as an important player on the world scene of health care. Ÿ Ÿ - Pearl Shaw January 2025 26 www.eurohealthleaders.com

31. Sometimes, it falls upon a generation to be great. You can be that great generation. Let your greatness blossom. “

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