Pharmacies in Greece continue to phase significant shortages in the supply of many medicines, while the implementation of the new positive drug list is delayed, leading to the delay of the implementation of the new price bulletin.
IHS Life Sciences perspective | |
Implications | Low prices in Greece continue be a cause of supply shortages on the Greek market, while the complexities of the pricing system continue to result in errors that slow the system down. |
Outlook | Given that it is highly unlikely that there will be price increases in the foreseeable future, a solution to the shortages of drugs in the market appears to be unachievable for some time. |
Shortages continue to be observed
There continue to be significant shortages of medicines at pharmacies in Greece, reports Greek medical news source Iatronet. The source reports that 350 medicines are currently in short supply in Greek pharmacies, and no solution to the stock-outs has been identified at this stage. Furthermore, the source states that it often was the case that pharmacists would not receive even 20% of their order, without any explanation from the "supplier side" (it was not specified whether this meant wholesalers or producers).
The source provides examples – in the case of an epilepsy medicine, during the course of 2015, there were orders from 11,000 pharmacies for 422,765 boxes, while wholesalers received only 34,614 boxes; additionally, pharmacists requested 270,206 boxes of an anti-cholesterol medicine given, but they received only 87,196. The source states furthermore that in the case of the same drug, pharmacies had requested 304,657 boxes in 2014, and had received only 100,000.
Iatronet reports that there are also shortages in cancer drugs, antihypertensives, anti-psychotics, as well as medicines to treat osteoporosis and Parkinson's disease.
Delays in implementation of new positive list, new price bulletin
Separately, Iatronet reports that there are delays to the implementation of the new positive drug list, as well as problems with the implementation of the most recent price bulletin. The source reports that until the approval of the new positive list appears in the Greek government gazette, the prices from the previous bulletin will apply – taking as its source of this information the Panhellenic Pharmaceutical Association (PFS), which represents pharmacists in Greece. According to the PFS, quoted by the source, the application of new prices in accordance with the price bulletin revealed first on 31 December 2015 is not possible yet, because the new reference prices are not published yet – they are due to be published in the new positive list. Owing to this delay, the electronic prescription organisation IDIKA was unable to calculate the reference values and then send them on to pharmacies.
Earlier, it had been reported by Greek medical news source Onmed that the adoption of the new positive list had been delayed, owing to some objections and submissions by companies – including Greek and multinational companies. The source also added that the positive list would include 21 new active substances, mostly for chronic or rare diseases.
Outlook and implications
The low prices for many medicines now in place in the Greek market has resulted in a number of efforts by the Greek authorities to implement bans on the parallel export of particular medicines – most of them innovative medicines close to or just beyond the end of their patent term. No such bans are currently in place, but anecdotal evidence from pharmacies suggests that the situation concerning the supply of the drugs involved has not improved.
It remains unclear what the cause of the limited supply is, and it is most likely a mix of factors, although all of them are almost certainly traceable back to low prices. Parallel exports are likely to be continuing, while producers themselves are likely to be withholding a proportion of their stock in order to avoid parallel exports.
Regarding the situation concerning delays with the introduction of the new positive list, this is a reminder of the complexities of the Greek pricing system and their propensity for errors and, consequently, delays. It is likely that some of the complaints submitted by producers relate to the reference prices that they have been offered in the new positive list. The fact that Greece's international reference pricing system is based on the collection of prices from 22 markets in the European Union certainly adds to the complexity in calculating prices, and therefore raises the likelihood of errors.