Impact of price reductions on pharmaceutical expenditure in greece
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Laboratory of Hygiene & Epidemiology, School of Public Health, University of West Attica Greece
Laboratory of Clinical Pharmacology, Faculty of Life Sciences, School of Medicine, Aristotle University of Thessaloniki
Laboratory of Pharmacogenomics and Individualized Therapy, Faculty of Life Sciences, Department of Pharmacy Greece
Barcelona School of Management, Pompeu Fabra University Greece
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A1823
Background and objective:
The annual re-pricing procedure in pharmaceutical products in Greece has been instituted as a measure to control public pharmaceutical expenditure. However, price reductions over the past decade, combined with increasing mandatory pharmaceutical industry’s contribution (clawbacks and rebates), have led to the withdrawal of low-cost treatments (retail price 2.5€ million at 2011. Total values and units were calculated along with their respective absolute and relative change during the period of 2011-2021.

Six ATC4 categories were included in the analysis, with a total expenditure of 90,657,197€ in 2011. In three of the respective categories, the change in units due to withdrawal of low-cost treatments, did not lead to an equivalent change in total expenditure. Specifically, the withdrawal of treatments in iron products, thyroid preparations and intestinal anti-inflammatory/anti-infective agents led to a change in units of 212%, 99.1% and -4.4% respectively. At the same time, the change in pharmaceutical expenditure for the aforementioned categories was 445% (30,254,755€), 182% (13,212,534€) and 18% (468,676€) respectively, with the cumulative expenditure increasing from 16,714,697€ to 60,750,762€. For the remaining categories, the withdrawal of low-cost treatments was associated with proportionate reduction in expenditure.

Price reductions are not panacea for the containment of pharmaceutical expenditure. The exclusion of low-cost treatments from further price reductions and/or clawbacks and rebates should be considered to ensure treatments’ viability by avoiding potential withdrawals, which can lead to increased pharmaceutical expenditure.

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