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Hungary aims at bigger bite of dental tourism

Hungary is a world superpower when it comes to dental tourism. Since 2008, Hungary has been the leading European country in this sector, as its share reaches 40% on the continent according to market estimates.

The history of dental tourism in Hungary started decades ago, when one dental clinic popped up after another near the western border of the country to meet the demand of Austrian and German patients coming for cheaper treatments. Over the following years, dental tourism evolved into a major attracting force of the country, and Budapest became the dental capital of Europe.

According not just to the advertisements of Hungarian dental clinics but to the sending countries’ media as well, the level of treatment available in Hungary is extremely high, with the level of service even surpassing that of the US or the UK. Services are extremely competitively priced compared with western countries, and Hungary is renowned for having a number of excellent dental accreditations and membership in international dental organizations.

There are no exact figures available on dental tourism, so data can be derived only from market estimates, publicly available balance sheets, and the reports of health organisations and the Central Statistics Office (KSH) in Hungary. However, Hungary has been the leading European country in this sector since 2008, as its share reaches 40% on the continent. Globally, one in five people looking for dental treatments abroad choose Hungary. Worldwide, the country is in a competition with Mexico, the famous dental tourism target of Americans, said Gábor Szakonyi, Vice President of the Association of Leading Hungarian Dental Clinics (ALHDC), and also managing director of the dental center VitalEurope.

According to a report of the Hungarian central tax bureau NAV, about 500 of the 2,600 domestic dental clinics or companies deal with a high proportion of foreign patients. Each year, some 60,000-70,000 people arrive in Hungary for dental treatments, generating a revenue of HUF 65 billion-70 billion in the dental sector alone. An additional HUF 13 billion-16 billion is generated in related industries such as hotels, catering and other services. In 2011, most of the dental tourists arrived from the UK, Germany, Italy, and France, said László Szűcs, Chairman-CEO of medical tourism office Orvosi Turizmus Iroda Zrt in an interview with DentalNet.

Overall statistics are also very hard to derive from the figures of clinics, as the number of foreign patients varies from dentist to dentist. At VitalEurope, the proportion of clients arriving from abroad can reach 80%. These visitors spend an average of one week and €4,000 in Hungary and save up to 60% compared to treatment prices back at home. The main sending countries are France, the UK, Norway, Italy and Germany.

However, Fedasz Clinic in Pilisvörösvár, near Budapest, reports only one tenth of its clients coming from abroad. Arriving from as close as Slovakia and as far as Canada and the US, they spend €1,400 and five days here on average, customer service manager Ferenc Görögh said.

Basically, these clinics try to collect clients on their own, through websites registered abroad or agents working for commission. Either way, clinics receive no direct help from the government. "Dental clinics receive no direct state aid, be it participation on a fair or appearances in the media. The sector is not in the focus of state marketing either. It achieved all of its progress and successes on its own," says Dr Attila Kámán, president of ALHDC and director of Implantcenter.

However, the sector being a leading revenue generator accounting for 90% of domestic health tourism revenue, the Hungarian authorities feel the need for continuous development of dental tourism. The first visible benefit of the cooperation between the government and the dental clinics was the HUF 1 billion funding the National Development Ministry reallocated into the tourism target budget for dental tourism development to ensure the necessary budget resources last year.

The decision received great coverage in national media, as it came just a week after Prime Minister Viktor Orbán promised financial support to participants of the first conference on the development of the dental tourism. The event was organised by the newly-registered program office Magyar Fogászati Turizmus Programiroda, which is co-owned by Orbán's dentist, Béla Bátorfi. Later Bátorfi claimed that neither him nor any companies owned by him have received any aid from national or EU funds, and added that, on moral grounds, he would not enter any tenders of this kind.

Beyond the aforementioned HUF 1 billion, government negotiations resulted in another net HUF 3.5 billion becoming available through the "Innovation in dentistry" program for dentists. But being a registered member of the Hungarian Dental Tourism Development Program is a condition for any application for these latter funds – according to Szűcs, this is the only way national targets can be achieved due to their complexity. The program aims to triple the number of patients visiting Hungary in five years, to stop the exodus of Hungarian dentists, and to make Hungary the worldwide leader of dental tourism by the end of 2015.

Participation in the program is voluntary, and EU and national funds can be reached through 15 other tenders, Szűcs pointed out. The basic membership fee is HUF 150,000, but the price of an "Innovation package," including all expenses of preparing, assembling and managing the Innovation in dentristry tenders, can reach up to HUF 2.8 million. Dental surgeries, dental technologists and dealers who had joined the Hungarian Dental Tourism Development Program have generated a turnover of HUF 53 billion-55 billion through 600,000 dentist-patient contacts.

But not everyone is happy with state participation in dental tourism. “VitalEurope took part successfully in EU and national tenders in the past without participation in the Dental Tourism Development Program. However, the membership required to participate in the program entails too many fees and obligations, which are not characteristics of the free market, so VitalEurope and other members of ALHDC do not participate in the program,” Szakonyi said.

Foreign competition, especially from Croatia, Turkey, Bulgaria, and Poland, is very dominant. These countries could compete with lower prices due to the quality of materials used and touristic opportunities supported by state aids and marketing, said Dr Kámán.

But also in the countries of origin, dentists have reduced their prices in recent years to levels that are often more competitive than those of dental surgeries established in neighboring countries. However, support coming from Hungarian state institutions is less than those in competing countries. In Turkey, the state pays half of the price of patients’ plane tickets when they arrive out of season for dental treatments. And in Estonia, the country's dental tourism opportunities are advertized abroad using the state budget. Dental tourists in Hungary spend half a million guest nights and billions of forints each year in hotels, restaurants, bars, sightseeing buses, museums, taxis, etc., but not a single image where Hungary is displayed as a potential destination for dental treatments was published by the state, Szakonyi added.

Hungarian airlines Malév’s filing for bankruptcy early in February 2012 hit tourism hard, according to experts. However, the increased presence of low-cost companies like Ryanair, easyJet and Wizzair brought relief, and no impact of the grounding of Malév can be felt. “We felt nothing, patients had come already with low-cost airlines or their own national airlines before Malév went bust,” Görögh said. But the loss of Malév reduced potential travel alternatives, which clearly has no beneficial effect on dental tourism.