Pharmaceutical Policies under Economic Crisis: The Greek case

Abstract

Introduction: The purpose of this paper is to critically assess the Pharmaceutical reforms implemented in Greece before and during the economic crisis. The effects of the crisis are multiple in terms of GDP reduction, severe cuts of health and pharmaceutical expenditures and the deterioration of the health status of the population. However, the crisis has been a “window opportunity” to implement the long anticipated reforms in the health sector. Methods: The analysis is based on Time series data from the OECD Health data source covering the period 1970-2014. Double Logarithmic models are explored to estimate income elasticity for pharmaceutical expenditures. The value of the income elasticity in the Pre-crisis period is 1.72 the highest in Europe. The average annual growth of Pharmaceutical expenditure in the pre-crisis period was 12.3% i.e. the highest among the EU-28 countries and during the crisis this rate dropped to -8.5% the lowest among the EU-28. Results: The evolution of thePharmaceutical policies and reforms are discussed with reference to HTA, Co-payments, Claw-back and the E-Prescribing. The mixture of both demand and supply side measures resulted in a substantial reduction of pharmaceutical expenditures from 5,6 bil. Euros in 2009 to 2 bil. Euros in 2016. One of the main contributing factors to cost containment policies is the effective launching of E-prescribing. Exclusion and deprivation of citizens of effective and innovative medicinal treatments should be avoided and their access to health services and medicines should be assured. The new strategy in medicinal products should ensure good quality at affordable prices. The Greek Government, in an attempt to reach the Memorandum objective of 1 percent of GDP on pharmaceutical spending should develop incentives to promote the use of generic medicines and the cost-effective use of medicines in general Conclusions: With all its pros and cons, Greece appears to be an interesting case study to assess the success and failures of the various pharmaceutical reforms implemented.