The Economic Adjustment Programme
Fifth Review – October 2011
Σημαντικές αναφορές της έκθεσης σε φαρμακεία και πολιτικές υγείας.
(Όλα τα σχόλια στα ελληνικά είναι από τον Γιώργο Κουτέπα).
Given the high share of public expenditure that is spent on healthcare, healthcare reform is a crucial component of Greece's fiscal consolidation efforts. These efforts will depend a lot on an efficient pricing of medicines, the proper accounting and monitoring of expenditure, modern procurement, invoicing and administration, the introduction of the positive list linked to the reference price system; the full implementation of the eprescription system and the concentration and specialisation of NHS hospitals and departments while ensuring mobility of staff.
These areas include: equalising contribution rates for EOPYY, i.e. increasing contribution rates for OGA;
reducing the number of administrative staff and the number of physicians contracted with EOPYY
Applying binding clinical and prescription guidelines, eventually linked to the e-prescription systemspeeding up the implementation of e-prescription (!) and minimising delays in invoicing and eliminating arrears (=καθυστερήσεις πληρωμών...) . This last point is particular important as some social security funds have not been able to collect the rebate from pharmacies when there are delays in payment
Increasing use of generic medicines - compulsory e-prescription by active substance and of less expensive generics when available
Associating a lower cost-sharing rate to generic medicines that have a significantly lower price than the reference price (lower than 60 percent of the reference price) on the basis of the experience of other EU countries;
-setting the maximum price of generics to 60 percent of the branded medicine with similar active substance.
Starting from 2012, pharmacies' profit margins are calculated as a flat amount or flat fee combined with a small profit margin with the aim of reducing the overall profit margin to no more than 15 percent, including on the most expensive drugs as defined in law 3816/2010.
(Είναι προφανές ότι μιλάει για το μέσο όρο του ποσοστού κέρδους και όχι για οριζόντια μείωση! Ειδικά με τη χρήση του συστήματος τιμολόγησης που προτείνει το ποσοστό είναι πλέον κλιμακωτό και σε αυτό οριζόντια μείωση δεν υφίσταται. O στόχος με την πλήρη χρήση του rebate και μικρή τροποποίηση του ποσοστού στα ΦΥΚ μαζί με υπολογισμό του όγκου πωλήσεων προσεγγίζεται και μένει να δούμε αν θα υπάρχει κάποια τυπική προσαρμογή στο σύστημα τιμολόγησης)
-publishes binding prescription guidelines for physicians defined by EOF on the basis of international prescription guidelines to ensure a cost-effective use of medicines; [July 2011]
-publishes and continuously updates the positive list of reimbursed medicines using the reference price system developed by EOF. [Q2-2011]
Ongoing with delays.
A large number of prescription guidelines have been developed and
await final agreement by the National Health Council. However, they
have not been published and they are not binding. This risks jeopardise
After some delay and following several rounds of consultation and
changes, the criteria for the positive price list and reference price
system for reimbursement has been published in September 2011. The
reference price system and positive list implementation are due to
EOPYY starts operating. The new fund will lead to a substantial reduction of administrative staff of at least 50 percent and of contracted doctors of at least 25 percent as compared to the four originating funds combined. The aim is to achieve a ratio of patients per doctor in line with the European average. [Q3-2011]