A Comparative Look at Lab Lines: The US-Ukraine Healthcare Crossroads

In this newsletter article, I’d like to explore the differences between the healthcare systems in Ukraine and the United States, focusing specifically on the collaboration between medical facilities and laboratories.

First, let’s acknowledge the American healthcare system for its integration of healthcare providers with laboratories and pharmacies. Here’s how it works: your doctor orders a test, you head to the lab, and voilà, your tests are already in their system. Just show your ID, and you’re good to go. This streamlined process is quite different from Ukraine’s system, where, at least before the full-scale war, you had to print out a referral (a piece of paper that could easily be lost), present it at the lab, return when your results were ready, and then schedule an appointment with your doctor to review these documents. These extra steps were both exhausting and time-consuming.

Similarly, in U.S. pharmacies, you can choose where you’d like to pick up your medication, and your prescription is sent there electronically. You even receive a notification when it’s ready for pickup. Ukraine has made significant strides in transitioning from traditional paper prescriptions to a more digital approach. As of April 1, 2023, the Ministry of Healthcare introduced e-prescriptions as an alternative to paper ones for all prescription medicines. This change has seen over 20,000 family doctors issuing e-prescriptions daily, benefiting more than 4,000 patients each day. However, unlike in the U.S., there is still no full integration with pharmacies in Ukraine. Patients receive their prescriptions digitally but must find pharmacies that have their medications in stock. While these initial steps are promising, full integration and convenience are still a work in progress in my native country.

On the other hand, the U.S. has its own challenges. Some laboratories here seem to be relics of the past. They may have been cutting-edge twenty years ago, but now some feel outdated. This phenomenon of early adoption followed by stagnation isn’t unique to labs; it occurs across many industries. In contrast, the laboratory scene in Ukraine, particularly with the Synevo European laboratory chain, is more modern. The clinics are well-maintained, offering a wide range of procedures, and the staff is friendly and professional. It stands out with its 350 labs spread across the country, from Kyiv to Kherson. They prioritize quality as much as quantity.

When I moved to the United States, coping with the healthcare system was a new challenge. My first experience with medical laboratories was with LabCorp, a name that seemed ubiquitous. From routine blood tests to specialized diagnostics, LabCorp appeared to be the go-to for everything. And for the past year that’s the only lab I went to, mostly because I was referred to do my blood work there by my PCP.?

So I asked myself whether it was a coincidence or does LabCorp has a potential monopoly in the clinical lab industry. My research showed that actually, LabCorp holds second place with about 21% of the market share while Quest Diagnostics at around 26%. Together, these two giants control a significant portion of the market. Other notable companies include Sonic Healthcare and BioReference Laboratories, holding approximately 8% and 5% of the market, respectively. Additionally, renowned institutions like ARUP Laboratories, Mayo Clinic Laboratories, and Stanford Health Care also contribute to the variety of laboratory services available. So no, it’s not a monopoly but still a lot of concentration of power among the two biggest players.?

The concern with monopolization, even when not absolute, lies in the potential to stifle competition, limit innovation, and drive up costs for patients. In both Ukraine and the US, a few companies’ control over a significant market share could potentially hinder smaller labs’ ability to compete, potentially limiting patient options and increasing prices for services. Thus, while these industry giants may bring efficiency and scale, the lack of diverse competition can lead to a less dynamic and more expensive market.

I’m planning on continuing my research in this space and would like to see if there is a change in market shares within the next few years. If main players continue to increase their control, there might be more concerns to raise.?

Anyway, my representative sample might not be very objective so please share your experience with American laboratories. It’s interesting to learn about your experience.?

Catch you in the next issue, and stay curious and healthy!