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SFEE General Assembly Resolution

Athens, April 2, 2026.- We are in a period of intense international and European developments that make the prospects for the economy, society and medicine in our country uncertain. Geopolitical tensions in the wider region and the volatility of the international pharmaceutical environment maintain an environment of increased uncertainty. The crisis in the Middle East, if prolonged, will bring significant economic burdens to the entire world.

At the same time, developments in the Middle East are putting pressure on exports, tourism, investment and the pharmaceutical sector, in an environment of reshaping the global economy, under the influence of the MFN (Most Favorable Nations) principle. Under these circumstances, complacency is not an option. At the same time, Europe has not yet sufficiently adapted to the new requirements of international competitiveness, while recent pharmaceutical legislation, although improved, is not enough to bridge the gap with the US and China.

At national level, challenges remain particularly acute. The pharmaceutical market in Greece continues to be under significant pressure, as public funding is growing at a significantly lower rate than total pharmaceutical expenditure (3.65% compared to 10.9% in 2019–2024). This tactic leads to a continuous and disproportionate increase of 20% per year in compulsory returns – they have now exceeded 58% on average. In the last four years, the contribution of the pharmaceutical industry to public pharmaceutical expenditure has been greater than that of the State, which is a European record – and probably a world record!

We should recognize the positive steps that have been taken by the State, such as the support to the RDP, the launch of the Innovation Fund and the strengthening of funding through the Recovery and Resilience Fund.

However, the existing funding gap remains. As a result, only one in five new innovative medicines becomes available in the country, while the excessive burden on the industry acts as a deterrent to innovation. Greece is the country with the lowest prices of original medicines combined with the highest reimbursements in Europe.

The absence of prescription control and the lack of a co-responsibility clause limit the incentives to effectively contain expenditure. According to recent estimates (Deloitte Study), total pharmaceutical expenditure may reach €10.5 billion. by 2028, with a further significant increase in rebates from industry in the absence of a revision of the financing policy.

The sustainability of the health system requires a coherent framework of reforms:

• Gradual strengthening of public funding and at the same time improvement of resource efficiency, through digital tools and enhanced controls. Medicines should be treated as an investment in public health, with significant indirect savings.
• Establishment of a cap on compulsory returns (clawback) and adoption of a framework of co-responsibility between the State and the pharmaceutical industry, as is the case in most other European countries.
• Incentives to strengthen investment activity, Research and Development (clinical trials), as well as cooperation between Greek and international businesses and academic institutions.

2026 may be a year that will bring rapid developments in the field of medicine. The existing cooperation with the State must be strengthened and yield measurable results. The value of innovation must be recognized substantially, both for patients and for the sustainability of the Health System. Additionally, linking innovation to domestic production and use of generics and biosimilars can be a critical driver of growth.

Despite the challenges, the pharmaceutical sector demonstrates remarkable resilience, contributing substantially to the national economy, with approximately 119,000 jobs and a 3.1% share of GDP. In order to maintain and further exploit the dynamics of the sector, the implementation of sustainable and effective solutions needs to be implemented immediately. The State is called upon to put Health and medicine at the center of its policy, with consistency and tangible results.

SFEE will continue to formulate evidence-based health policy proposals, with the aim of ensuring a sustainable and resilient health system, the effective representation of its members and, above all, the unhindered access of Greek patients to the necessary treatments. Especially at this juncture, more than ever, the unified voice of the industry is the ultimate challenge that can bring us closer to sustainable solutions.

Through its initiatives, SFEE will continue to highlight the critical juncture in the health system and pharmaceutical policy, clearly posing a key question: will we, as a country, choose to invest in a modern, financially sustainable health system that promotes innovation, enhances research and ensures timely access for patients to new treatment options? Or will we allow the perpetuation of chronic distortions that undermine both the functioning of the system and the well-being of patients?

The future of health is not self-evident. It’s a choice. Because improving the health of citizens is a prerequisite for a strong and sustainable economy.