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Study by SFEE in collaboration with the London School of Economics

Athens, March 7, 2025.-  The challenges, the economic footprint on health systems and the reforms that need to be made in order to improve the quality of life of patients with diabetes and better manage the disease are included in the study “The Burden of Diabetes and the Prospects for Reform: Conclusions for the National Health System”, which was commissioned by the Diabetes Platform of SFEE at the London School of Economics (LSE). In the presentation of the study, οn Thursday, March 6, 2025 at the Athens Club, the political leadership of the Ministry of Health, the European Diabetes Forum, representatives of scientific societies, patient associations, and pharmaceutical companies exchanged fruitful ideas, submitted proposals and discussed the obstacles and opportunities that exist in dealing with the disease and formulating realistic and applicable solutions. The study, which highlights both the challenges faced by diabetes patients and the health system, as well as evidence-based policy reform proposals inspired by international best practices, was presented by LSE Professor Panos Kanavos.

It is important to note that for the first time a roundtable discussion was held with all stakeholders on diabetes, and also for the first time in years, the most up-to-date data on diabetes were presented in a consolidated form. The aim of the meeting was to strengthen the dialogue between all stakeholders and implement proposals that could lead to the improvement of diabetes care in Greece.

The issue of diabetes is of great concern to us, noted the Minister of Health Adonis Georgiadis , who was present at the discussion. “Obviously, our diet and our lifestyle play a decisive role, in the first place. It is disheartening in Greece to have the lowest percentage of the population that exercises. Good health is first and foremost our personal responsibility,” the health minister said at the beginning of his speech. He stressed that we have a huge problem to deal with: “The change in technology compared to traditional glucose test strips has resulted in more reliable measurements for patients, but on the other hand it has led to an explosive increase in the budget. The extra funding in 2024 was a drop in the ocean. To give an example, the cost for EOPYY per quarter for patients was 300 euros with the old technology and with the new one it was 1,400 euros. We lack this money and we need to find it,” Georgiades noted, explaining that the main reason for introducing the rebate on medical devices was to direct the extra resources entirely to the diabetes budget. “If we don’t act quickly there will be a problem. In any case, the issue of diabetes is primary and prevention is important. Its complications carry an even greater burden,” he said and in closing, he called on participants to propose immediate actions to control, prevent and treat diabetes that will have a real effect.

As noted by Olympios Papadimitriou, President Association of Greek Pharmaceutical Companies, diabetes in our country concerns at least one million of our fellow citizens and the “burden” on the public health system is heavy. “It is a chronic, but also insidious disease, as at the beginning it may not give visible symptoms, but it burdens the health system many years after the first diagnosis. It is also accompanied by serious complications that place a heavy burden on health budgets,” he said. For these reasons, he added, this study is very important for mapping the situation in the Greek environment and the practices we need to implement. “What we are asking for is to come up with common priorities and immediate actions that the Ministry of Health will be able to immediately proceed with and implement,” the SFEE President noted.

Bart Torbeyns, Director-General, European Diabetes Forum, said that the priorities are to bring together all stakeholders to tackle diabetes, to record the problems and the proposals that exist. “61 million people in Europe are living with diabetes. Prevention is important, but there are still gaps in data collection on the incidence of the disease. The registration and monitoring of patients is crucial, as today 1 in 2 patients remain undiagnosed, while there is an increase in childhood diabetes. We are in contact with all stakeholders and governments to identify suggestions that can help. I also wish that in Greece the Government will help in order to improve the quality of life of patients with diabetes”, he underlined.

The main points of the study

The study “The Burden of Diabetes and the Prospects for Reform: Conclusions for the National Health System” is a comprehensive understanding of the impact of diabetes on Greek society and focuses on addressing two critical realities: the increasing financial burden of the disease, as well as the capacity of the health system to respond to its far-reaching consequences.

Presenting the study, LSE Professor Panos Kanavos said that its main objective was to capture the challenges, identify best practices that could be applied in our country and highlight opportunities for the transition to integrated forms of care, utilizing digitalization and the potential of pharmaceutical research.

Referring to the main findings of the study, he stressed that deaths from diabetes are increasing, but we do not yet have the overall picture (as only deaths that indicate diabetes on the death certificate are counted), and at the same time the prevalence of the disease in our country is increasing (to 12%). At the same time, there are gaps in registration systems and problems in patients’ access to healthcare and disease management. Diabetes is among the top ten causes of death and the death rate from the disease has risen from 1.4% to 2%.

“Challenges in dealing with disease can become opportunities. We have few and fragmented data that makes it difficult to treat the disease, hinders monitoring and the formulation of a National Plan to tackle the disease,” he said. It called for the removal of barriers to patients’ access to urban centres, but especially in the periphery where many problems are identified, for health technology assessment capacities to be further developed, but also for emphasis to be placed on mental health.

Effective diabetes management requires preventive and holistic approaches, which include comprehensive care strategies targeting these interrelated health challenges. Greece’s ability to cope with the growing burden of diabetes and provide comprehensive care is improving, but the health system is not progressing at a pace significant enough to have the impact it needs.

The Greek health system – like many of the European systems – has limited data collection and analysis capabilities, which makes it difficult to fully assess the true burden of diabetes and its associated costs. However, it is well known that Greece faces a significant challenge in managing diabetes in its population. The prevalence of diabetes in Greece is reported at 12% and is increasing, although the exact rate is not clear.

As a result, there is very limited real-world data on the incidence and epidemiology of complications in the country, their management in clinical practice, and the care outcomes achieved for people with type 1 and type 2 diabetes.

Over the past decade, Greece has made efforts to strengthen the role of primary care in diabetes management, recognizing the need to address care fragmentation and provide patients with a clear first point of contact in the health system, as well as a structured pathway for diagnosis, treatment and monitoring. While the Greek health system faces many challenges in providing consistent and high-quality diabetes care, these challenges also represent significant opportunities for reform.  The implementation of substantial changes requires careful consideration of resource allocation, competing priorities and the long-term sustainability of interventions. These include:

– Adoption of a National Diabetes Strategy: A comprehensive national diabetes strategy should serve as a guiding guide to improve diabetes prevention, management and long-term care in Greece.

Strengthening Primary Care Capacity to Manage Diabetes: Strengthening the role of primary care in diabetes management is crucial to reduce pressure on specialist services and ensure timely interventions.

– Investing in Data Infrastructure to Improve Interoperability and Analysis: Improving data collection, integration, and utilization is critical for data-driven decision-making and effective diabetes care.

Facilitating Integrated Care for People with Diabetes: To improve health outcomes and reduce hospitalizations, Greece needs to strengthen the integration of diabetes care at different levels of the health system.

Advancing Health Technology Assessment (HTA) capabilities for Digital Health Technologies: Adopting innovative digital health solutions can transform diabetes care, but Greece needs a robust assessment framework to ensure cost-effectiveness and clinical value.

By implementing these strategic reforms, Greece can create a more efficient and sustainable diabetes care system, ultimately improving the health and well-being of its population, while reducing the economic burden of the disease.

In the discussion that followed, Mr. Aris Angelis, Secretary General of Strategic Planning of the Ministry of Health, Mrs. Vasiliki Vassiliou, Secretary General of the Hellenic Endocrine Society, Mrs. Eugenia Vlachou, Member of the Board of Directors of the Foundation of European Nurses in Diabetes (FEND), Mr. Christos Daramilas, President of the Panhellenic Federation of Associations – Associations of People with Diabetes Mellitus, Mr. Philippos-Richard Domayer, President Hellenic Diabetes Network in Primary Health Care, Mrs. Chara Kani, Head of the Drug Division of EOPYY, Mr. George Kochiadakis, former President Hellenic Society of Cardiology, Mrs. Sofia Manea, President of the Panhellenic Association for the Fight against Juvenile Diabetes, Mr. Elias Mygdalis, Member of the Board of Directors of the Hellenic Society of Internal Medicine, Mr. Dimitrios Skoutas, President Hellenic Society for the Study and Education of Diabetes Mellitus, Mrs. Sofia Tsiakalou, President Hellenic Federation for Diabetes, and Mr. Spyros Filiotis, Vice President and General Manager of Pharmaserve – Lilly SA.

In closing, SFEE President Olympios Papadimitriou thanked all participants and stressed that political will to address the problems and the need to collect and record data are also necessary.

See the infographic in English here.

See the presentation file here.