That’s how change can be achieved
Άρθρο του Προέδρου του ΣΦΕΕ, κου Κ. Φρουζή στο «European Business Review» (Μάρτιος 2014))
We have the obligation to be optimistic. We should see the positive side in any difficulty. We should recognize and extract the opportunity out of adversity. And that’s what I will do in this brief article concerning the pharmaceutical industry in Greece in times of crisis. However, we should not shy away from reality and its dismal facts. Acknowledging them is the only path towards change. Let’s start over by accepting that investing in health is the pillar of any respectful society. Western countries and the advanced economies of the word have firmly based their prosperity in safeguarding and raising health standards for the general population. It has been observed that declining health standards lead to a spiral where poor health and social inequality lead to diminishing economic results and vice versa.
It would have been expected that this scientific observation would have been the fundamental point of reference. This common truth should have had the capacity to guide minds in every decision making process about the stabilization of the economy in times of crisis. It didn’t happen in Greece. SFEE is concerned that despite the dire warnings from all fronts, pharmaceutical expenditure for 2014 is about to drop below the 2,3 billion euro threshold dimmed as the lowest possible by most experts for sustaining a European health system. Indeed, it is about to reach only 1,92 billion, which is utterly insufficient. If it materializes, then from 2014 Greece gets far below the 50% of the European average expenditure for medicines.
Hence, the public health deterioration in Greece is an alarming reality. There is clear evidence that the cuts in State drug budget did not focus on “fat”. Cuts were not designed in a way to ensure the sustainability of health care. Instead, they have directly affected the investment on health – which is translated in a deterioration of life expectancy and quality of life. This is socially unacceptable and it should be stopped.
Medicines are the pinnacle of the health revolution of the last 4 decades. When pharmaceutical expenditure is over squeezed, the general health structure is severely hit because insufficient access to medicines leads to a number of negative developments: Deceases getting stronger, more people get ill and unproductive and the health system is stressed by more days of care in hospitals for each patient. This is particularly true for new and innovative medicines that Greece has practically lost access – especially for new medicines released in the last 3,5 years. Through an elaborate web of bureaucratic decision processes, innovative medicines are effectively banned as doctors are prevented to prescribe while in some cases pharmaceutical companies are prevented to distribute.
This strategy on pharmaceuticals has been adopted as an emergency way to cut the general expenditure in the national budget. However, it has not been realized that the qualitative aspect of cuts is far more important that the cuts themselves. Unrealistic pharmaceutical cuts not only generate suffering and social injustice but also create an even higher indirect fiscal expenditure as far more people get hospitalized and drop themselves out of the economic activity.
All the above should be seen in light of the dire situation in hospitals where a diminishing number of health professionals find themselves in a constant quest to defend health standards – sometimes without the proper medicines and general infrastructure. This policy is self-defeating and it should be changed. The ever shrinking health expenditure leads to shrinking health standards and life expectancy. A stabilization process where the benefits of shrinking expenditure are written off by the combined human, social and financial costs is a process in urgent need of review and redesign.
SFEE, the industry Association, has shown a high sense of responsibility in the five-year crisis. Pharmaceutical companies are the most badly hit by a number of unjust, often horizontal, state decisions (pricing below the average of 3 lowest pricing EU countries, severe delays in pricing for new medicines, deep haircuts of state bonds, clawbacks, recession in the market and heavy taxation). However, in an insecure financial environment where refinancing operations are few and limited, the pharmaceutical sector not only defended public health by fulfilling its role in the Health System but it also supported Greek production and has given new opportunities to most of its labor force. Greek pharmaceutical companies even expanded in new research projects and clinical trials that attracted funds, respect and recognition from the global industry and the international scientific community.
There’s no question that we have actively helped to balance the public pharmaceutical budget while we ensured patient’s access to innovative treatments and generic medicines. We have put special emphasis to the fact that the fund given to Health Care consists an investment for a productive society and not an expenditure for the accounting system at the state. The result of this investment is the added value for the Economy and the social cohesion, through the seamless patients’ access to therapies and new medicines. According to more recent studies the total contribution of the pharmaceutical industry in the national economy (direct, indirect and induced effect) is estimated to 7,55 billion euros while the total number of the job positions supported by the development of the industry in Greece is 132.780.
What all these mean? It means that pharmaceutical industry, while the most badly hit by the crisis, it endured and fulfilled its role as a pillar of public health. It also means that repairing the damage and raising health standards, which is a fundamental need in today’s Greece, cannot be done without the active partnership between the state and the industry. The most bold and forward looking decision would have been the cooperation of the Industry with the government and, with the contribution of other health experts, to redesign the Health System in a way that would have been modern, strong and cost-effective. What is less acknowledged is that the Greek Pharmaceutical Sector incorporates the knowledge of the best practices that are followed across the world. Today is the day to join our forces so to transcend past defects and build a Greece Health System and Health Sector for the decades to come. That’s how change can be achieved.