Pharmaceuticals in Greece: a “drahmatic” future

Interview with Konstantinos Frouzis, head of the Association of Pharmaceutical Industries in Greece, – 30/11/2014

by Dan Alexe in the New Europe Studios

KF: I could say that our pharmaceutical companies, either multinational or local, are actually working to shape the environment. We desperately need in Greece a more predictable landscape, and we are all contributing to that.

NE: Are you regulated by law? Or do you have an internal table of rules and regulations?

KF: We have our internal rules, we have very strict regulations, indeed.

NE: Is there such an association in every EU country?

KF: Yes, there is such an association in each country, and there is also a mother association in Brussels called EFPIA, European Federation of Pharmaceutical Companies and Associations.

NE: Do regulations differ much from one country to another?

KF: The essence of each regulation is to try to shape a sustainable health care environment in each country for patients, as well as for the entrepreneurship. Of course, there are also local peculiarities.

NE: Like what? Can you give an example?

KF: Health is much more foreseeable, in the good sense, in the northern countries. More predictable, but strict. On the other hand, southern Europe, as you can imagine, is more volatile.

NE: What do you do to combat the general fear of price fixing?

KF: It’s a wide-spread fear. Unjustified.

NE: But how can one justify the high price of some medicines against grave diseases such as AIDS or Ebola?

KF: At our level in Greece, we have a very simple mathematical algorithm, which makes us have the lowest prices among the 28 EU members. So for us, it’s a very easy equation. We wanted, during this period of crisis, to have low prices, in order to help the population.

NE: Can you compare the EU market with the American market?

KF: The American market is much bigger, much more inclined towards innovation. That’s why the prices of drugs there are considerably high. On the other hand, the generic prices are very, very low. It’s a contrasted situation.

NE: There has been a health reform in Greece recently…

KF: Every year. Every year we are having a health reform. Our association is interacting regularly with the state.

NE: Speaking of the crisis, the Greek market must have been affected by the crisis, if people cannot afford medicine anymore.

KF: Considerably. The public spending went down from 5.5 billion euros in 2009 to 2 billion this year, it’s a loss of 64 %.

NE: So health services must be affected.

KF: Very much, yes, co-payment levees are increased for patients, and the margins for pharmacies are considerably lowered. Everything is squeezed now.

NE: Does that mean that a doctor will deliver a prescription to a patient, but that the patient wouldn’t be able to use it, because he cannot afford to pay for it?

KF: Yes, this might happen.

NE: Can you do anything for that? Your association?

KF: No, we are just the producers. Currently, we are are delivering each year 2.6 billion euros of drugs to the Greek population, and we are paid back two billion. This means that 600 million euros, through discounts or other procedures, are given for free to the population.

NE: And who pays for that?

KF: We do. The industry. It’s a very difficult financial situation.

NE: Do you also have an internal algorithm for spreading the risks and covering the losses?

KF: Each company contributes to the market share.

NE: So, do you foresee any way out of this crisis? In terms of immediate health of the people?

KF: Our purpose, during this crisis, is to maintain patient access to therapies. That is our duty inside the industry and also our duty to the stakeholders, including to physicians, or pharmacists. I think that we managed to maintain a quite affordable level of access for patients, although the situation remains very critical. This is a turning point, because we have a lot of uninsured population in Greece, after all the loss of jobs, and that is why we need to be very cautious when the government, for instance, is shaping the budget for 2015. We are there to discuss with them how to make it more affordable for the industry, but mainly for patients and citizens.

NE: You’ve been head of this association through many governments. Could you feel a difference between a left-oriented and a right-oriented government? In terms of policy towards public health?

KF: I think that more and more, all governments are social-driven, because they need to maintain the social balance, and at the same time try to support economical development in Greece. Nevertheless, I tend to think that leftist parties are more inclined to support citizens in this sense.

NE: Well, they have to justify their ideology. How long have you been head of the Association?

KF: Almost three years.

NE: What was your worst moment?

KF: Worst moment? I might think it was years ago, when we were experiencing the dilemma between drachma and euro. A very uncertain period for Greece and for the pharmaceutical industry. Even now, we might have to return from euro to drachma if we want to avoid bankruptcy.

NE: A “drahmatic” future, then…

KF: Yes. We avoided bankruptcy until now, but we did experience very difficult times, myself and my colleagues in the other companies in Greece, all trying to maintain their investments, their products, their employment. It’s been very critical for the whole country, and for the pharmaceutical industry.

NE: And what was your best moment?

KF: The best moment is now, because I think we escaped from this…

NE: You feel that you escaped?

KF: I think that we escaped, yes. Of course, the crisis is still there, most of all in Greece. But it’s a different crisis now. We now have costs at a very low level, and we need to be clever enough in order to allocate resources towards the right expenses.

NE: How many health ministers have you met?

KF: In almost eight years? Uh, seven ministers.

NE: Did you feel any difference between them?

KF: To be honest, at one year per minister, or fifteen months per minister, it’s not the ideal situation for someone to do the job correctly.

NE: Do you foresee a future with a healthier population, a healthier planet, people who will live longer, be more healthy, with fewer diseases?

KF: Every year, we are gaining a longer lifespan thanks to the medicines and new therapies. The last 40 years, if I’m not wrong, we gained ten years of life prolongation. So, I think that, as an industry, our duty is to try to prolong life, and I think that we are advancing quite well, as long as governments around the planet keep providing the necessary investments for health care to the citizens. And we are there to urge the governments to participate in this health care revolution.

NE: But in a world with no diseases, you would go bankrupt.

KF: I don’t think so.

NE: True, we’ll always have the hangover to cure… and will need the Viagra.

KF: Yes, yes, you are right. But we shouldn’t overdo it.