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Press Release

The new Ministry of Health measures
cut down hope for patients

Devastating consequences for the public health system and
for the viability of the pharmaceutical industry

Athens, 14 December 2016.- The proposed new measures of the Ministry of Health prove to be disastrous for both the right of Greek patients to unhindered and fair access to the necessary treatments and for public health and the viability of the pharmaceutical industry. This was highlighted at a press conference held today by the Hellenic Association of Pharmaceutical Companies (SFEE).
Against the background of an already ailing public health budget – public pharmaceutical expenditure in Greece is 50% of the European average – SFEE officials pointed to the risk of pharmaceutical poverty and to the devastating consequences of the new measures, which practically represent a threat from a humanitarian and social viewpoint. Specifically, the new pharmaceutical policy measures cut down hope for Greek patients because:

• they hamper the access of the seriously and chronically ill to innovative treatments, by delaying the launch of new and crucial medicinal products on the domestic market for up to four years. Such products can only be introduced in Greece if they are reimbursed in 14 EU countries (of which seven must participate in the voluntary health technology assessment (HTA) system). Four years of delay for patients whose only hope is access to an innovative treatment is tantamount to a sentence to a life of suffering or, worse yet, no life at all. Those patients do not have the luxury of time;
• moreover, they penalize new medicines through an extra rebate of 25%, bringing the total burden to more than 60% (volume rebate 20% + extra rebate 25% for new medicines + claw-back 17% on average). Also considering that Greece as a reference country contributes to the formation of the lowest prices in the EU, one can easily understand the huge toll taken on the sector, with Greek patients being the ultimate losers.

Furthermore, as noted, the new measures threaten the viability of the pharmaceutical industry which has long reached a point where it cannot take any more pressure.

• Public pharmaceutical expenditure, which has undergone continuous cuts in recent years, is now subject to a ceiling of EUR 1,945 million plus EUR 570 million for hospitals; this amount is insufficient, hence expenditure keeps spiralling out of control. This is because it was determined arbitrarily, without listening to the real needs of Greek patients, the burden on tertiary healthcare and the soaring numbers of uninsured people. The gap is covered, on one hand, by patients themselves (out-of-pocket patient costs almost tripled from 9% in 2009 to 26% on average in 2015) and, on the other, by the industry which finances 25% of pharmaceutical expenditure through rebates and claw-backs. That is, one in four medicines used is paid for by the pharmaceutical industry.
• As if that were not enough, the government is now acting to squeeze more and more money out of pharmaceutical companies: on top of the already stifling claw-backs and rebates, it tries to exact more revenues from the industry. To illustrate the situation that companies are expected to deal with, the claw-back to EOPYY increased by 42.3% in the first half of 2016 year-on-year, whereas the newly introduced hospital claw-back came to EUR 140 million (41% of expenditure) and is likely to double by the end of this year. In a budget of EUR 570 million, this is far more that the industry’s fair share of the burden.
• Amid this situation, the government, instead of taking measures to reduce the unreasonable and unfair claw-back by 30% in 2017 – as required under a MoU commitment – in fact substitutes a reduced claw-back with a higher rebate. This threatens the survival of pharmaceutical companies, jeopardizes thousands of jobs, and creates disinvestment conditions in the industry.

On his part, the Vice President of SFEE, Mr. Konstantinos Panagoulias, said: “The proposed pharmaceutical policy measures of the Ministry of Health represent a major step back, as they cancel the unhindered access of Greek patients to the treatments they need, making them second-class Europeans, with reduced rights and expectations. This is a horrible development that affects our most vulnerable fellow citizens. The new measures threaten the viability of the pharmaceutical industry which has long reached a point where it cannot take any more pressure. We have to do with real pharmaceutical poverty. And as if that were not enough, on top of the already stifling claw-backs and rebates, the government tries to exact more revenues from the industry. The contribution of the pharmaceutical sector to health, the economy and growth is decisive. According to the latest European Commission report, Greece is below the EU average in terms of public pharmaceutical expenditure. The industry should be seen not as a threat but as an investment, an investment in health. If the pharmaceutical industry were not to survive, the public health system would not survive either; Greek patients would remain without access to high-quality health services; and the growth prospects of the Greek economy would be deprived of a key pillar. Pharmaceuticals are the solution, not the problem.”
On this occasion, SFEE officials and representatives stated that they had submitted to the Ministry of Health a set of feasible, cost-effective and successfully tried solutions, which were never discussed; solutions that respect the country’s budgetary capabilities and commitments but were provocatively ignored.

Outlining the effects of the new measures, the President of SFEE, Mr. Pascal Apostolides, noted: “Greek patients are losing the right to the hope offered by the advances of science across today’s world. They are losing rights that had never been lost before. By these measures they become second-class citizens and are subject to conditions of higher inequality. The State must, first and foremost, decide on what health system, of what quality level, it wants for the country, for Greek citizens and patients. Does it want to lose what the Greek society has achieved in recent decades in terms of health? Does it want Greece to compare with countries that geographically do not belong in Europe? Does crisis-stricken Greece want to support an industry that demonstrably is a driver of economic growth? If the answer is yes, then different policies are needed. Even at the last moment, these changes must be stopped and not be implemented”. And Mr. Apostolides concluded: “The Government must work cooperatively and rationally in the best interests of Greek patients and of the economy, and should assess, in a timely and pragmatic manner, the real consequences of its policy choices. Let us not forget that good intentions with wrong actions produce disastrous results.“