Greece’s pharmaceutical industry is again facing mounting pressure over hospital medicines expenditure and delayed payments, raising concerns about the sector’s viability and patients’ access to medicines.
Clawbacks for the 2024 hospital pharmaceutical budget came in marginally lower than 2023’s critical levels, remaining at an unsustainable peak, according to the industry. This prompted an immediate reaction from industry representatives, who sent letters to the Minister of Health requesting an urgent meeting to address the pressing issues.
Clawbacks are considered “the amount pharmaceutical companies have to return to the state when public spending on drugs exceeds the budget.”
The mandatory returns rate for the largest portion of the market — medicines priced above €30 —reached 75% in 2024 (80% in 2023). As Mihalis Himonas, general manager of the Hellenic Federation of Pharmaceutical Companies (SFEE), explained to Euractiv, it was expected to be around 69%.
“Greece cannot sustain a hospital clawback of more than 70% in 2024 on medicines priced over €30, many of them innovative and essential for patients,” Labrina Barmpetaki, president of the PhARMA Innovation Forum (PIF), told Euractiv.
According to the associations representing the innovative industry, the current system penalises innovation, disproportionately affecting patented medicines above €30, and the fragmentation of hospital budgets by therapeutic category creates inequities and complexity.
€15 million ‘micro-injection’
On 3 November, Minister Adonis Georgiadis met with over 45 participants, including CEOs from pharmaceutical companies and representatives from all pharma associations. There, he announced a €15 million increase to the 2024 hospital pharmaceutical budget, a move the industry mainly deemed symbolic.
“It is clearly not sufficient,” Himonas argued, with Barmpetaki noting that “A one-off €15 million injection – cutting the burden by only about 2 to 2.5 percentage points – does not address the root cause of structurally high mandatory returns.”
The issue of further increasing the budget will be a focal point in a follow-up meeting with the minister of finance, expected next week.
Barmpetaki welcomed the minister’s engagement and the intention to involve the ministry of finance, but she warns that patients and the life sciences ecosystem cannot wait.
“The government must act now and move from temporary offsets to a permanent, structural solution: adequate public funding of pharmaceutical care, targeted structural reforms, and a predictable, transparent policy with shared-responsibility mechanisms that reward innovation and safeguard access,” she noted.
Double trouble
Rising mandatory returns and the underfunding of pharmaceutical expenditure are coupled with liquidity issues, according to the letter SFEE sent to Georgiadis.
They report severe cash-flow shortages due to long delays in hospital and central procurement agency (EKAPY) payments, with arrears exceeding ten months.
The association cautions that this threatens the continuity of hospital medicine supply.
Meanwhile, the ministry of development granted a 50-day extension for pharmaceutical companies’ general assemblies, acknowledging delays in finalising financial statements due to late clawback calculations.
Additionally, SFEE raised the subject of the planned split of the budget for retail medicines into three separate budgets: on-patent medicines, off-patent and generics.
Opposing such a decision, the association argued that it protects some categories of medicines and leaves others unprotected, “which leads to a lack of predictability.”
The ministry also plans to implement SPC filters for prescription control next year, while the full integration of public hospitals into the electronic prescription system is scheduled to be completed by January 1, 2026.
Urgent action needed
“Without decisive action, companies face an untenable environment that will delay or deter launches and clinical research, and Greek patients will continue to wait longer than their European peers,” Barmpetaki warned.
That is why a concrete, time-bound plan with the collaboration of the industry is important.
SFEE also recognises ministry efforts to rationalise the system and to establish the Transitional Reimbursement Scheme (Innovation Fund), which is set to launch at the start of 2026.
“However, we believe that further corrective measures are necessary, as well as a fundamental reassessment of pharmaceutical funding, taking into account the vital need to strengthen innovation, which is so essential for the health and well-being of Greek citizens,” Himonas added.
“The mandate is simple and urgent: reform the clawback, secure sustainable funding, and restore confidence in Greece’s ecosystem,” Barmpetaki concluded.
[BM]
