GREECE : Pharmaceutical pricing and reimbursement policies in the in- and out-patient sector
out - patient sector
POM OTC
(reimbursed/non reimbursed)
National Organization for Medicines (EOF)
PRICING
Statutory Pricing
Task: annual review of prices; Retail price, Wholesaler Task: annual review of prices;
price, Ex-factory price; sunset clause indicated retail price
in - patient sector
Criteria: External Reference Pricing (average of the two Criteria: External Reference Pricing
POM to be purchased by hospitals + OTC
lowest prices in Eurozone, increases of prices up to 10% (average of the two lowest prices in
under certain conditions); Generic price is set at the 65% of Eurozone or even one, increases with
the originator price no restrictions) National Organization for Medicines (EOF)
Retail price = ex-factory + regressive wholesale and pharmacy Indicated retail price = ex-
margins (%) by price ranges + VAT (6%, 13% or 24%) factory + VAT (6%, 13% or 24%) Task: Setting the maximum hospital price = ex-factory – 8.74%
Assessment and Reimbursement Negotiation Assessment and Reimbursement Committee Minister of Health
Committee Committee
ASSESSMENT
Technology Assessment Final opinion-appraisal Final Decision
- Clinical benefit
Price
Medicines - Relative effectiveness
Negotiation Reports and recommendation for use Inclusion or not to the
- Cost-Effectiveness
- Budget impact reimbursement list
EOPYY
EOPYY
Task: healthcare services provision
Task: reimbursement of medicines to community pharmacies
3 Levels of Reimbursement
Task: reimbursement of high cost medicines dispensed through EOPYY’s
25%: in general
pharmacies
10%: chronic diseases
REIMBURSEMENT
0%: Some Chronically ill and patients with paraplegia, tetraplegia
Ministry of Health
PAYMENT
Patients belonging to low income/vulnerable groups
Women during pregnancy and lactation
Task: reimbursement of medicines for in-patients and of high cost medicinal
products for outpatients in public sector
Internal Reference Pricing
The reference price in ATC4 level is the weighted average generic price with
the lowest-cost daily dose (the generics taken into account need to
Close budgets
represent 20% of the total sales volume in the last 6 months of the given
Community Pharmacies and EOPYY: There is an annual budget cap for
cluster).
medicines dispensed through private pharmacies and EOPYY (excluding high
cost medicines for hospital use) (2018: 1,945 billion€)
High Cost Medicines
High cost medicines are dispensed through EOPYY’s pharmacies and Hospital Hospital expenditure (public) : There is an annual budget cap for medicines
Pharmacies (purchased at hospital price minus 5%) with exemption from dispensed purchased by public hospitals (2018: 550 million€)
cost-sharing.
LEGISLATION
AUTHORS
1. Law 4512/2018 (Official Gazette A’ 5/17.01.2018): articles 247-256 set the rules of HTA and Negotiation -Chara Kani, Pharmacist, MSc, PhD, Head of Planning and Monitoring
Committee) Department of Drug Administration, Medicines Division EOPYY,
tel.: 0030 210 811 06 55 ; e-mail: ckani@eopyy.gov.gr
2. Law 4583/2018 (Official Gazette A’212/18.12.2018): article 212 sets one price review per year
-Vicky Koutrafouri, Pharmacist, MSc, PhD, Deputy Head of Pricing
3. Law 4600/2019 (Official Gazette 43/09.03.2019): article 161 sets the new country basket and the average of Department, Administration Division EOF,
the two lowest prices in Eurozone. tel.: 0030 213 20 40 425 ; e-mail.: vkoutra@eof.gr
