Pharmaceutical Pricing Policy in Greece: Toward a Different Path

Abstract

BackgroundAffordable, accessible, and innovation-promoting pharmaceutical care is essential to the operation of a sustainable health system. External reference pricing (ERP), a common pharmaceutical policy in Europe, suffers today from indigenous weaknesses that may cause market distortions and barriers to care, burdening mostly the weak economies, and hence, raising ethical and political worrying.Objectives and methodsA non-randomized experiment was conducted, in order to examine the influence of flexible and adaptable to health systems’ affordability ERP structures. Outcomes were assessed by measuring deviations from Greek prices’ level ex ante, as well as effects on pharmaceutical markets affiliated to the European ERP system.Results and conclusionPharmaceutical pricing models that fit prices to income and affordability are better in all aspects, as they produce fairer results, while resulting in low external costs for the European ERP network as a whole. Small sets of reference countries are preferred to large baskets, as they produce similar results, while presenting better qualities by increasing the flexibility of the reimbursement system and the transparency of the market.

Clinical audit as a tool to optimize contracted private healthcare provision: Testing the waters in resource-deprived Greece

“…The years 2010 and 2011 show lower overall proposed cut rates relative to previous years – this is due to the country having already entered deep austerity and medical devices’ prices being substantially (50%–70%) decreased by the state, thus removing motives for supplier-induced demand. 15 …”

“…In addition, arrears of close to 90 million euros had accumulated over said period towards private hospitals. 19 …”

“…Up until 2011, despite health coverage being heavily social insurance based – compulsory social health insurance covers over 95% of the population 15 – and social insurance contracting and reimbursing services of private healthcare providers, including hospitals, clinical audit had been only partially utilized to assess the appropriateness of service provision in private practice, the only audit mechanism in the case of Health Care Organization for Public Servants (OPAD) being the annual appointment of mostly non-specialized physicians as part-time auditors. 15 This annual cycle of recruitment, followed by audit training, led to considerable delays in actual audit of hospitalization records, with a large number of cases pending clearance and arrears threatening the financial planning and sustainability of the organization.…”

“…15 This annual cycle of recruitment, followed by audit training, led to considerable delays in actual audit of hospitalization records, with a large number of cases pending clearance and arrears threatening the financial planning and sustainability of the organization.…”

“…This allowed the expenditure for private hospitalizations in OPAD, the sole insurer of all public servants in Greece, responsible for purchasing services for over 1.5 million insureds, to double between 2004 and 2009, 15,16 when the country entered the austerity period. As a result, private hospital expenditure became a key driver of cost-cutting mandates from the country’s creditors.…”