Expert view from Greece #OpGreekmedicin

 

     Τhe issue with the medicines in Greece is not a simple one. it has several aspects including pricing policies, distribution channels, wholesalers, approval/circulation of generics, prescribers and prescribing practices...

     

    The Ministry of Health considered that the high indeeed expenditure on medicines was the only culprit for the high cost of heathcare, despite the fact that it contributed only with a small % on the total cost of healthcare.

   

    So it set as goal to reduce only the medicines expenditure but without a strategy, it took horizontal measures that indeed brought down the cost of medicines but this did not mean in fact a rationalisation of the sector despite a few measures that could have considerable impact if implemented rightly e.g. e-prescribing and e-referral. Instead it caused other silos of negative effects. The Ministry tried to come in terms with powerful health professional organisations without taking into consideration the needs of the patients, who have never sat at the negotiations table with the other partners in healthcare...

   

    In May 2011, the accumulated overdue debt to pharma, which for the last many years was a routine phenomenon (pharma delivered to public hospitals and social insurance funds against credit, overdue for months if not years in a row..) led Roche and Novo Nordisk to stop deliveries, as long as they were not paid...

   

    In September, more companies declared that they will deliver only against cash. Besides the settlement of the overdue debt, several other issues intervened in the "medicines market" issue eg. the rebate that pharma should make to the government on the price, the hours of operation of the pharmacies, the conditions to open a pharmacy, the possibility of wholesalers to export imported drugs to other countries where they had higher prices, the directed prescribing, the inherent financial and organisational weaknesses of EOPPY, the new organisation for social insurance for healthcare and more...

   

    Besides cutting down on medicines expenditure, the Ministry at the beginning of the year requested the management of the public hospitals to cut down their budgets by a hefty 40%approx. and on the other hand their financing was very limited. Recently, the social insecurity that reigns after the May 6 elections and the reduction of available financing made the hospitals be very conservative with their spending, cutting down on expensive drugs as are the cancer drugs, those for patients with transplants, etc. so that they can cover their basic operation needs. All this coupled with medicines market issues led to a gradual disappearance since April of basic expensive cancer drugs e.g. Herceptin, Zometa,etc.

   

    The result is that patients are taken hostages in a fight that does not concerne them. It is not without significance that among the missing drugs are some expensive ones that should be taken by patients at exact dates...Patients who cannot access their medicines are desperate, and announcements that are not true, only add to their anger and desperaton. Take the announcement of Friday, that medicines would be available by the pharmacy of the largest hospital in Athens, that made patients running downtown to the hospital only to find out that its pharmacy is closed every Friday!!

   

     If health and healthcare are not anymore a social good as it is stated in the constitution, citizens should know about it. However, political parties that announced their programs this week-end carefully avoided to state their position on health/healthcare issues. Health industry that was mistrusted by patients for a number of reasons, should not be surprised if it sees that mistrust towards industry grows... Industry and trade have the power to help ease the acute situation with medicines in Greece.. the question is do they really want to...

 

      The foregoing is my five cents to the problem!! Do not claim it's the only view or the most complete... Just wrote from heart...The issue is not politics but to convince pharma to deliver at least some small quantities of key medicines to ease the situation... Regarding the posting for drugs availability at ELPIS hospital  this has to be verified...I have seen and commented on it.  Anyhow, this is a long week-end for Greece,  Monday is a holiday and all shops including pharmacies (except those on call)..

     

     

      All pharma companies should be addressed, they all operate in Greece - but judging from reaction of key pharma official at conf.in London  last week - who when asked what his company plans to do with medicines shortage in Greece said he does not know of any shortages!!! - I wonder what the reaction of the local branch offices will be...Anyhow one has to try... and I will try to see what's the situation with Elpis hosp.

 

 

You will find the list of the pharma operating in Greece at www.sfee.gr under members but for some reason their server is down now - try later... and the greek pharma that is local manufacturers mostly of generics under www.pfe.gr under members is the list.

 

      Doctors of the world could serve as depository of unused or remaining drugs (by the way  it's something they do already if I am correct) with patients or carers of patients. An alert has also been placed over the week-end on the FB pages of cancer patient orgs to share unused/remaining drugs....