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Address by the President of SFEE, Mr. Olympios Papadimitriou, at the Annual New Year’s Reception

Dear Ministers,

Dear representatives of the parties and institutional bodies,

Dear representatives of the Patients’ Associations,

Dear Representatives of the Media,

Dear colleagues,

Welcome to the annual event of the Hellenic Association of Pharmaceutical Companies for the New Year’s Reception.

On behalf of the entire Board of Directors, I would like to thank you warmly for your honorary presence and wish everyone, from the bottom of my heart, a happy 2026 with health and every personal, family and professional success.

Ladies and gentlemen,

As we bid farewell to 2025 and welcome 2026, we do so against the backdrop of significant global and European developments, which are shaping an increasingly uncertain economic and social landscape, as well as the future of medicine in our country.

The challenges are many:

On the one hand, geopolitical developments in our broader geographical neighborhood show no signs of de-escalation. On the other hand, U.S. policy under President Trump is marked by constant shifts and uncertainty. From a strategic perspective, our country appears to be strengthening its position in the Eastern Mediterranean through closer relations with the United States and active participation in regional alliances. From an economic standpoint, however, international trade policies and persistent geopolitical uncertainty pose significant challenges to exports, tourism, investment, and the pharmaceutical sector.

In this context, the global economic landscape is being reshaped, with significant implications for the pharmaceutical sector, particularly in light of the Most-Favoured Nation (MFN) principle. Only a few weeks ago, the United States and the United Kingdom concluded an agreement aimed at increasing the net prices of on-patent medicines and reducing rebates and clawback mechanisms. The ultimate objective of this arrangement is to exert downward pressure on on-patent medicine prices in the United States, while simultaneously extending pricing pressure to other European markets.

This policy is expected to have direct implications for the majority of European countries, extending beyond the 25 countries currently included in the MFN framework. For this reason, although the Government considers that this development does not directly affect our country, it is important not to be complacent, a position we fully share.

At the same time, the United States appears to be moving away from the Green Deal framework, thereby further enhancing its international competitiveness.

On the other hand, Europe has not yet adequately adapted to the evolving conditions of international competitiveness. In particular, with regard to the new European Pharmaceutical Legislation, the agreement reached in December on the patent ecosystem, setting a maximum protection period of 11 years, constitutes an improvement compared to the European Commission’s initial proposal. However, it does not appear sufficient to close the existing competitiveness gap with the United States and China and, moreover, does not represent an improvement compared to the framework previously in force.

This development underscores Europe’s slow responsiveness and largely corroborates the findings outlined in Mario Draghi’s recent report concerning the structural lag in European competitiveness.

Let’s now focus on our domestic challenges:

The pharmaceutical market in Greece has been under sustained pressure in recent years, with 2025 proving no exception. Public pharmaceutical funding continues to grow at a notably slow pace, despite total pharmaceutical expenditure increasing at double-digit rates. Specifically, during the period 2019–2024, public funding rose at an average annual rate of 3.65%, while total pharmaceutical expenditure expanded at an average annual rate of 10.9%. This persistent asymmetry in the State’s funding approach has inevitably resulted in a sharp escalation of mandatory returns, which increased at an average annual rate of approximately 20% over the same period.

We acknowledge that the current Government, and in particular the Minister of Health, Adonis Georgiadis, has taken steps in the right direction. These include the initiation of the process for the establishment of the Innovation Fund, as well as the strengthening of pharmaceutical expenditure, broadly in line with the provisions of the RRF. Nevertheless, despite these efforts, the available resources remain insufficient. A particularly concerning consequence of this underfunding is that, according to the most recent studies by IQVIA, only 1 in 5 new innovative medicines reaches the Greek market. Regrettably, the situation is expected to deteriorate further, as the existing funding gap persists.

Another area in which the actions of the Ministry of Health send a positive signal concerns the implementation of multiple prevention campaigns, for which credit is due to Agapidaki. Nevertheless, these initiatives must be accompanied by additional pharmaceutical funding, in order to ensure the immediate coverage of treatments for patients diagnosed with disease.

At the same time, the work of the Deputy Minister of Health, Themistocleous, in the area of hospitals and infrastructure, as well as that of Vartzopoulos in the field of mental health, is duly acknowledged. Overall, meaningful efforts are being undertaken within the Ministry of Health; however, in the area of pharmaceuticals, tangible and measurable outcomes have yet to be delivered.

Greece has the lowest prices for on-patent medicines in Europe while simultaneously imposing the highest levels of mandatory returns, placing the country in an extreme and unsustainable position within the European pharmaceutical landscape.

Although pricing rules across distribution channels are broadly harmonized, there are significant disparities in the levels of mandatory returns. Moreover, in recent years, the State has focused primarily on redistributing compulsory returns among selected categories of medicines for temporary relief, rather than implementing structural measures aimed at their substantial and lasting reduction.

Myths and Realities:

This approach appears to be grounded in a series of entrenched misconceptions that, over the years, have become embedded in the State’s perception of the pharmaceutical sector. However, it is essential to distinguish between perception and reality?

1. Myth: Pharmaceutical companies increase public pharmaceutical expenditure and are therefore responsible for the inefficiencies of the healthcare system.

Reality: On average, pharmaceutical companies retain only 38% of the final value of the medicines they place on the market. Moreover, the pharmaceutical industry as a whole does not derive a substantial financial benefit from increases in gross pharmaceutical expenditure. Any such increase benefits the system only insofar as it is accompanied by a corresponding rise in public pharmaceutical funding, irrespective of increases in the volume of consumption.

2. Myth: There is adequate and equal access to medicines for all citizens.

Reality: Of the 173 medicinal products approved by the European Medicines Agency (EMA) during the period 2020–2023, only 45 came to Greece through the standard distribution channels, representing just 23%. Moreover, for several medicines that are supplied to the country via IFET, equal access cannot be considered assured, as there is no clear evidence that all patients in need actually receive them. At the same time, IFET appears to be positioning itself to become the largest pharmaceutical supplier in Greece.

3. Myth: The increase in pharmaceutical expenditure is largely due to the overprescription of medicines.

Reality: There is no evidence of overconsumption in terms of the volume of pharmaceutical products in the market. Available studies indicate that, across many basic ATC categories (based on the OECD classification), Greece records consumption levels (measured in Defined Daily Doses – DDDs) that are lower than, or at least comparable to, the European Union average. Furthermore, annual expenditure growth rates do not deviate from those observed in other EU Member States.

Ladies and gentlemen,

The limited effectiveness of demand control mechanisms and of the prescribing mix, namely, the allocation of prescriptions by therapeutic indication, combined with persistent long-term underfunding that fails to keep pace with the growth of gross pharmaceutical expenditure, perpetuates an unsustainable system. This situation undermines patients’ access to essential medicines, particularly innovative therapies.

Over the past four years, the pharmaceutical industry has contributed more to total pharmaceutical expenditure through mandatory returns (clawbacks and rebates) than the State itself, an arrangement without precedent in any other European country. Furthermore, the predictability of public expenditure ensured by the current returns mechanism, together with the absence of a co-responsibility clause, weakens the State’s incentive to promptly implement structural measures aimed at effectively containing overall pharmaceutical expenditure.

With modest calculations, the gross expenditure on the medicine can reach €10.5 billion. by 2028, as shown by a recent study by Deloitte, and industry returns will increase by an additional €1.5 billion, if the state funding plan remains, as announced.

Medicines should be regarded as an investment in public health and in the prevention of future healthcare costs. Evidence shows that for every €1 invested in medicines, up to €4 are saved in overall healthcare expenditure.

Investing in medicines is therefore a strategic choice with measurable economic and social returns.

Inevitably, this raises a number of critical questions:

Why are pharmaceutical companies considered, at least in practice, to be solely responsible for increases in pharmaceutical expenditure and for the derailment of compulsory returns mechanisms?

Why are pharmaceutical companies repeatedly called upon to assume the financial obligations arising at the end of each year from an unbalanced pharmaceutical expenditure management policy, while the Government’s role remains confined to expressions of intent rather than binding commitments with clearly defined and measurable outcomes?

Dear Minister,

2026 may be a year that will bring rapid developments in the field of medicine.

SFEE’s proposals over time have been realistic and are articulated around three strategic pillars:

• Investment in medicines: with substantial public pharmaceutical funding, which will cover the real needs of the Greek population.
• Completion and implementation of all announced reforms, to control demand and the prescription mix and effective management of resources, through the utilization of modern digital tools
• Strengthening incentives for R&D investments: The State must establish additional and targeted incentives to make the country an attractive destination for investments in clinical trials, which bring significant benefits to patients, the health system and the national economy.

The first two pillars can be addressed through a single measure: the introduction of a co-responsibility clause for expenditures exceeding the predetermined ceiling, as already implemented in other countries such as Cyprus, Belgium, Italy, and the United Kingdom. At this stage, it is important for the Government to demonstrate the necessary resolve by undertaking binding obligations; intentions alone are insufficient, what is required are clear and enforceable commitments.

The value of innovation for both patients and Public Health, as well as for the Health System itself, must be institutionally and substantially recognised, as it can lead to significant savings.

Innovative treatments change lives. Indicatively:

• Between 2011 and 2022, the survival rate of patients with stage IV melanoma has more than doubled (based on Dutch survival rates), thanks to the introduction of immunotherapies and targeted therapies.
• The introduction of a new biological therapy gave hope to patients with rheumatoid arthritis: one year after the administration (of the biological therapy), 75% of the patients showed no evidence of disease progression.
• People with cystic fibrosis live up to 80% longer.
• Patients with multiple sclerosis, with the use of disease-modifying medicines, have a 32% lower risk of death over 20 years.
• Children with spinal muscular atrophy see a two-year unsupported survival increase from 10% to 80%.
• People living with type 1 diabetes experience, on average, a gain of approximately 15 additional years of life.
• New therapeutic options for type 2 diabetes are increasingly evolving into multi-purpose treatments addressing nearly the full spectrum of cardio-metabolic syndrome, while significantly reducing the reliance on insulin therapy.
• Hepatitis C can now be eradicated.
• People living with HIV currently have a life expectancy similar to that of the general population.

Innovation is not merely scientific progress; it translates into more time, a better quality of life, and renewed hope for the future.

In this context, the State should proceed with the systematic preparation of cost-effectiveness analyses and the structured collection of data, so that these can be effectively used both in policy formulation and in negotiations with pharmaceutical companies, as well as in decisions concerning the reimbursement of new treatments.

It is better and more honest for a therapy that is not considered beneficial not to be reimbursed at all, rather than being grouped with effective therapies and reimbursed in a way that undermines companies and raises serious ethical concerns about continuing to supply certain products in the country.

In conclusion, the strategic integration of pharmaceutical innovation with the production of high-quality generics and biosimilars in Greek manufacturing facilities can serve as a powerful catalyst for national growth. Strengthening the domestic pharmaceutical industry, combined with targeted investments and partnerships between Greek and international pharmaceutical companies, has the potential to generate added value, create new jobs, and enhance technological expertise, while simultaneously ensuring uninterrupted patient access to safe and effective treatments. Under these conditions, Greece can evolve into a robust production and export hub for medicines in Southeastern Europe.

Ladies and gentlemen,

Every new year begins with the hope that change will come, that the State will listen to some of our proposals and that efforts will be strengthened to transform intentions into concrete actions.

Let us see whether hope will prevail once again… for another year.

Thank you very much, and Happy New Year to all.