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Further rebates drive Greek pharma to brink

This article was originally published in Scrip

Executive Summary

The latest rebates being imposed by the Greek government are excessive and subject to "dubious" methods of calculation, and they threaten to destroy the pharma sector leading to job cuts, increased burden on the state and medicine shortages. So says the Hellenic Association of Pharmaceutical Companies, SFEE, in a letter to the minister of health and social solidarity, Christos Kittas (a professor at the University of Athens medical school who succeeded Andreas Loverdos on 17 May as part of the caretaker government put in place until new parliamentary elections on 17 June).

According to the latest decision of the Greek authorities, all prescribed medicines reimbursed by social insurance funds, EOPYY (the largest state healthcare provider) and the Seamen's Insurance Fund are subject to a rebate of 9% on the producer/importer's ex-factory price. On top of this basic rebate, additional quarterly rebates must be paid on total sales according to the sales volume of each product. This "escalated rebate" ranges from 2% on quarterly sales over €400,000 to 8% on sales over €2.5 million.

SFEE points out in its letter that the previous basic rebate of 4% on 65% of sales (equating to around 2.6%) has already been tripled by the new standard rebate alone, and that the additional rebate is "unbearable" and "burdens disproportionately the prices of the innovative on-patent products".

Furthermore, it argues that the criteria for the imposition of the escalated rebate "are not transparent" and "the ability to calculate precisely the total volume of each medicinal product is dubious". According to the new measures, introduced earlier in May under Mr Loverdos's watch, the sales volumes will be calculated according to the quantity of each product supplied as reported through the new e-prescribing system, although the Seamen's Insurance Fund and some of the social insurance bodies are not part of this, and will have to immediately scan all prescriptions dating back to 1 January 2012.

Escalated quarterly sales rebates on medicinal products in Greece1

Quarterly total sales volume per medicinal product

 

Additional rebate amount

 

€400,000-800,000

 

2%

 

€800,001-1,500,000

 

4%

 

€1,500,001-2,500,000

 

6%

 

€2,500,001

 

8%

 

1 in addition to the 9% standard rebate on all medicinal product sales

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