Yfantopoulos John N, Chantzaras Athanasios
School of Economics and Political Sciences, National and Kapodistrian University of Athens, Athens, Greece.
School of Economics and Political Sciences, National and Kapodistrian University of Athens, Athens, Greece.
Value Health Reg Issues. 2018 Sep;16:66-73. doi: 10.1016/j.vhri.2018.06.006. Epub 2018 Sep 5.
To provide a detailed overview of the recent reforms in pharmaceutical pricing and reimbursement processes as well as in other important areas of the pharmaceutical policy in Greece.
Information was collected via a structured questionnaire. The study used publicly available resources, such as publications, relevant legislation, and statistical data, while health experts were also consulted.
Recent pharmaceutical reforms included significant price cuts, increased co-payments and some provisions for vulnerable groups, rebates/clawbacks, mandatory electronic prescribing and prescription by international nonproprietary name, generics substitution, prescription limits and detailed auditing, centralized procurement, as well as changes in the pricing and reimbursement processes, with the introduction of positive and negative lists and an internal price referencing system. Price lists are compiled by the National Organization for Medicines and are issued by the Ministry of Health (MoH). An advisory pricing committee comprising representatives of stakeholder groups was abolished in early 2018. Nevertheless, under the new provisions, a health technology assessment body for the economic evaluation of reimbursed drugs is to be established for the first time in Greece. The committee is to be staffed by experts appointed by a ministerial decision of the MoH. The specific features of the process are yet to be determined.
The pricing and reimbursement decision-making processes are centralized under the competence of the MoH. Despite the good intentions of the reformers, there are still some aspects of transparency, equity, and long-term sustainability that remain under question in Greece.
详细概述希腊近期在药品定价和报销流程以及药品政策其他重要领域的改革情况。
通过结构化问卷收集信息。该研究利用了公开可用资源,如出版物、相关立法和统计数据,同时还咨询了健康专家。
近期的药品改革包括大幅降价、增加自付费用以及针对弱势群体的一些规定、回扣/追回款项、强制电子处方和采用国际非专利名称开处方、仿制药替代、处方限制和详细审计、集中采购,以及定价和报销流程的变化,引入了正面和负面清单以及内部价格参考系统。价格清单由国家药品组织编制,由卫生部发布。一个由利益相关者团体代表组成的咨询定价委员会于2018年初被废除。然而,根据新规定,希腊将首次设立一个用于对报销药品进行经济评估的卫生技术评估机构。该委员会将由卫生部部长决定任命的专家组成。该流程的具体特点尚待确定。
定价和报销决策流程在卫生部的职权范围内实现了集中化。尽管改革者有良好的意图,但希腊在透明度、公平性和长期可持续性的某些方面仍存在问题。