The Greek Health Care Reform After Troika's Involvement: The Potential Impact on Global Pricing and Access Strategy

Troika's measures to support Greece’s financial recovery have targeted all sectors of economy including health care. Since 2012, policy reforms have changed the way health care is funded, managed and delivered, and how pharmaceuticals are priced, accessed and reimbursed. This study examines the changes to the Greek system and tries to understand the wider possible impact on global pricing and access strategies. To better understand the recent reforms we conducted a literature review of public domain sources, including the Greek Government Gazette, PubMed and other websites. Searches were conducted in English and Greek-language, and materials were translated into English. From our findings a road map diagram was developed, and this was validated by interviews with health policy experts. Part of troika's campaign to reduce public spending has seen the Greek government focus on pharmaceutical markets and introduce policies to contain costs. The drug budget for 2014 has been cut to 2 billion euros, a billion lower than 2013. Considerable price cuts have been agreed on both novel and generic agents on top of clawbacks and rebates for high cost drugs. Prescribing is controlled through electronic prescription and physician budget caps. Introduction of price-volume agreements and risk sharing schemes are being considered, however the infrastructure to support implementation is still under development. Demonstrating value by health economics and outcomes research can still help manufacturers to achieve premiums. With a small population and an ever-decreasing expenditure on health care, it is tempting to overlook Greece when developing a product launch strategy. However, with Greek drug prices being referenced by several EU and non-EU countries, ignoring Greece may no longer be an option, especially when considering the indirect effect on the big EU5 prices. Understanding the reforms and assessing the impact on launch sequencing will be key in developing optimal pricing strategies.