Web Press Conference of SFEE
The future of the National Healthcare System
The pharmaceutical industry as a catalyst for a strong public health and economic development
Athens, May 28, 2020. – Having full conscience of its role as a responsible social partner, SFEE presented its proposals for a strong, sustainable and efficient National Public Health System and Pharmaceutical Policy, to the benefit of the patient and Greek economy.
At the current time conjecture, critical not only for the medicines industry but also for the country itself, whilst the first and successful round of the fight against the pandemic draws to an end, based on the new data and circumstances, the SFEE BoD President, Mr. Olympios Papadimitriou and the Director General, Mr. Michael Himonas, presented a cohesive plan of realistic and integrated proposals, structured in 7 action pillars. The SFEE representatives pointed out that the strategic plan proposed – already submitted to the government and the Prime Minister himself – is the product of a thorough and extensive study, as well as the offspring of the industry’s long and rich experience, and takes into consideration both the international and domestic data as well as the data produced by the recent special survey and study conducted (Deloitte 2020).
The first Pillar concerns the redefinition of the Pharmaceutical Budget which is without any further doubt insufficient and does not cover the real needs of the country. While the whole of Europe is currently reviewing Health expenditure, it is high time medicine budget in our country were reconsidered on a realistic and scientific basis: Taking into account the historic, epidemiological and demographic data as well as the entry of new medicines (horizon scanning) and the patent expiration of older ones. Dealing with the problem of excessive prescribing and taking into control all the cost centres in the field of Health, beyond that of medicines, in order to find the necessary resources without, of course, ignoring neither the country’s fiscal capacity not the sustainability prospects of pharmaceutical companies. Earmarking, in parallel, an additional budget line for prevention (vaccines) and rapid response in a flexible way in cases of exacerbated needs, as demonstrated during the COVID-19 crisis.
The second Pillar concerns the enhancement of the efforts for boosting the efficacy of the Public Health System, with a view to acquiring a rational and efficient System. The proposed goal setting is based on a new patients’ management architecture that substitutes the Hospital-centered system and provides for the radical change in the attitude in the use of medicines. It will be put the emphasis on primary care, integrating best practices from abroad, and introduce processes of continuous assessment, efficacy and efficiency control as well as fully implement and make use of instruments and reforms which, though existing, are not fully exploited.
The third Pillar regards the reassessment of the mechanism of clawback, the latter being the main menace to the system sustainability because of its continuous and uncontrollable increase. As pointed out by the SFEE representatives, there is common understanding that the repayment mechanism should operate as a safety net, protecting the ecosystem against excessive expenditure risks. Nevertheless, the system currently does not grant incentives for a change in actions, on the contrary, it perpetuates ailments, since it merely rolls over the excessive cost to the pharmaceutical companies instead of dealing with the causes producing this excessive expenditure. A comparison between the 1st quarter of 2020 data and the respective of the 1st quarter of 2019 demonstrate an increase in the excess by 45% in relation to the previous year. Three (3) successive European Commission Surveillance Reports (June 2019, November 2019 and February 2020) set the alarm that the mandatory refunds mechanism (clawback) causes moral hazard and is not sustainable. The State seems to have understood the problem but now it is high time it acted upon.
Viewing in detail the 3rd pillar actions, it was underscored that the mandatory rebates and clawback mechanism can operate as an investment incentive and acquire a development character through its fair revision and rationalisation, as well as the co-responsibility of the Pharmaceutical Industry and the State (introduction of a ceiling in the contribution of the pharma industry which will be abated on an annual basis and will be investing a share in pharmaceutical innovation). It was proposed, additionally, that all involved parties participate in the expenditure, through the implementation of risk-sharing, that the IFET (Pharmaceutical Research & Technology Institute) expenditure be exempted from the pharmaceutical budget line and that the expenditure overruns be calculated on the actual prices that companies sell and not the retail price.
The fourth pillar regards the assistance of patients’ access to innovative therapies.
The goal of proposed actions is securing an affordable, equitable and timely access of new innovative therapies in the Greek market, through an effective, dynamic and continuous process of Health Technology Assessment (HTA). The restructuring of the process constitutes a result-focused proposal, in an effort to reinstate the importation of new products in the Greek market – already late by two years approximately – placing the emphasis on pharmaceutical innovation.
The exploitation of clinical studies, harmonisation with the European practices, lifting of barriers and smart solutions for sustainable funding – such as the creation of a pharmaceutical innovation fund – constitute the interventions necessary for the Greeks to maintain hopes and the right to access to all benefits that can be drawn from scientific and technological progress.
The fifth pillar regards the growth dimension of the sector and the promotion of investments. In this new economy paradigm the country needs, pharmaceutical industry can be pivotal. Innovation, extrovert character, exploitation of scientific personnel and qualitative production are already integrated in its modus operandi. It is not mere chance that it constitutes the third export sector of the country. The creation of a stable institutional and fiscal environment and the adoption of favourable incentives (fiscal, financial, institutional etc.) create a development framework that can attract high-value and high-return investments, repatriate part of the scientific brain drain and constitute a model of co-operation between domestic and foreign companies, through the adoption of an open innovation paradigm. A field where the first signs, such as a 200% rebate on investment for research and development, are definitely encouraging, as the SFEE representatives pointed out.
In the field of clinical research, at the same time, the offset of clawback with investments in clinical research is a significantly positive step, which must be further enhanced with the increase of the respective budget line, so as to multiply the investments in clinical trials in our country and the benefits drawn for all: patients, hospital and health system infrastructure, national economy. In such a context, Greece could become a Clinical Studies Hub. While at that, it was also stressed that high level public health system and access to new innovative therapies constitute the basis for the exploitation of the silver economy model, which can offer multiple benefits to Greek economy.
The sixth pillar is the further exploitation of digital technologies in the operation and administration of all the agencies involved in the value chain of the Greek healthcare.
The success of the digital leap effected in Public Administration, in an extremely brief time span while in the grips of the pandemic, showed that the goal is attainable. The integration of all systems (medicines prescription, consumables, lab tests), the use of digital capacity for purposes of process monitoring as well as health data exploiting, with a view to tapping health data for the identification of trends in healthcare and medicines expenditure constitute significant actions that can lead to immediately to efficient monitoring, resource saving, services optimization and effective policy drafting in the field of healthcare.
The seventh pillar regards the promotion of a strong State-Pharma industry co-operation framework and the promotion of social responsibility and solidarity. The adoption of good practices, the compliance with and promotion of legality and transparency, the ethical operation of the health system on the basis of codes of conduct, they all constitute necessary prerequisites for the fair and equitable access of all Greek patients to the therapies deemed necessary for each, the support of Greek scientists and their work, the promotion of medical science and the Public Healthcare System, as well as the manifestation of positive and healthy entrepreneurship. Parallel to all that, the boosting of the Pharma-State co-operation in programs of disease prevention, identification, registration etc., can produce strong benefits for both society and the health system.
As noted by the SFEE President, Mr. Olympios Papadimitriou, “The timely adoption of protection measures against COVID-19 by the State has propelled our country to the international spotlight, ranking our country at the pinnacle of successful crisis management models, and has offered our Health system valuable time so as to effectively address the health crisis in absolute success. The State, health professionals and citizens, we all rose above ourselves and stereotypes, demonstrating spirit of collaboration, solidarity, efficacy and discipline. This forms a huge legacy for the future. Following a long economic crisis marked by the adoption of doubtful fiscal measures management which have caused a significant toll on the Public Health System, amongst others, Greece is now offered the opportunity to review and modernize its perception of systemic structure of the healthcare system. This success must be capitalized now. We should put a final end to age-long ailments still persisting. We should proceed in an orderly manner and make a leap or progress, needed now more than ever”.
“Our sector is ready to contribute with pragmatic proposals and actively support the elaboration and implementation of a national planning for Public Health. In a spirit of mutual understanding and support. The same spirit our sector has demonstrated throughout the period of economic crisis that proceeded – and we are proud of it. Our proposals aim at a sustainable medicine policy creating value for all, while at the same time, through the adoption of an active and supportive policy, the pharma industry can become a strong boosting power and enhance the competitiveness of Greek economy in the new production paradigm” underscore in his closing lines the SFEE President.
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