Contiades Xenophon, Golna Christina, Souliotis Kyriakos
Centre for European Constitutional Law, Athens, Greece.
Health Policy. 2007 Jun;82(1):116-29. doi: 10.1016/j.healthpol.2006.09.003. Epub 2006 Oct 17.
This paper examines the economic, political and legal characteristics of the Greek pharmaceutical market, which is largely affected by the paradox of state intervention: while pharmaceutical regulation is mainly directed towards a rationalisation of total pharmaceutical expenditure, all measures taken to date aim at exhaustive pricing controls, i.e. interventions on the supply side alone, disregarding the "balloon" effect of shrinking prices on the expanding volume of consumption. As a result, pharmaceutical expenditure has been steadily rising, adding a disproportional burden on both social insurance and private income. The "unconstitutionality" of current pricing regulations exerted further pressure for a comprehensive reform. The paper proposes an alternative regulatory paradigm, which is loosely founded on European experience with regulating pharmaceutical markets. The conclusions of the economic, political and constitutional analysis help formulate a proposal for a comprehensive pharmaceutical policy that could assure the financial viability of the system as well as adhere to the principle of "legality", as the latter is constitutionally defined.
本文考察了希腊药品市场的经济、政治和法律特征,该市场在很大程度上受到国家干预悖论的影响:尽管药品监管主要旨在实现药品总支出的合理化,但迄今为止采取的所有措施都旨在进行详尽的价格控制,即仅对供应侧进行干预,而忽视了价格下降对不断扩大的消费量产生的“气球”效应。结果,药品支出一直在稳步上升,给社会保险和私人收入都带来了不成比例的负担。当前定价法规的“违宪性”进一步推动了全面改革的压力。本文提出了一种替代性监管范式,该范式大致基于欧洲药品市场监管经验。经济、政治和宪法分析的结论有助于制定一项全面的药品政策提案,该提案既能确保系统的财务可行性,又能遵循宪法所定义的“合法性”原则。