Filenews 15 March 2022 - by Marilena Panagi
Upheaval among citizens and daily tensions in GHS pharmacies. Citizens have found themselves paying three and four times as many contributions when carrying out their prescriptions, while other fewer have to pay less.
The phenomenon has been observed mainly since the beginning of February, when the price list of pharmaceutical products was revised by the Pharmaceutical Services of the Ministry of Health (as it happens every year), with the process resulting, this time, in increases in the prices of 494 drugs and decreases in another 1,682 formulations, a fact that affected the amounts that citizens pay to get their medicines through the GHS, since in 192 cases there was an increase in 'contribution II' and in 72 a decrease.
The fluctuations in the amounts that citizens pay during the execution of GHS prescriptions are of course a phenomenon that is not observed only once a year and only when the price list is revised by the Ministry of Health, since the reasons for which the amount of contributions changes are a total of four and specifically these changes are observed (in addition to the price revision):
- When they join the GHS, products are cheaper in the same category.
- When the patent breaks and generics come in.
- When a drug that was unique in its class ceases to be, because another corresponding more cheaper was incorporated.
"F" attempts to clarify the scene by analyzing, with the help of the HIO, the reasons why citizens often see changes in the amounts they are asked to pay when carrying out their prescriptions in GHS pharmacies.
Fluctuations due to price revision
The prices of the formulations included in the price list of medicines, which is prepared by the Pharmaceutical Services of the Ministry of Health, fluctuate depending on the average prices at which each formulation is available in the reference countries of the Pricing System. Specifically, the maximum wholesale prices of medicines are determined by the Pharmaceutical Services of the Ministry of Health and not by the Health Insurance Organization, using the "reference pricing" method and are derived from the average of the maximum wholesale prices of specific reference countries plus 3% for import costs. The countries used are: Expensive countries, Austria, Denmark, Germany, medium countries, Belgium, Spain, Italy, Sweden, cheap countries, France, Greece, Portugal.
During the above procedure, the price list of medicines was revised again this year by the competent service of the Ministry of Health and since the revision, for 494 drugs there was an increase in their price and for 1,682 a decrease. This resulted in the GHS's List of Pharmaceutical Products to affect the "contributions II" of citizens, since according to HIO data, in 192 formulations the "contribution II" increased and for 72 decreased.
Against this background, citizens who previously received one of the 192 formulations affected are now paying a higher contribution to get their medicine than previously, and citizens who received one of the 72 formulations affected inversely, are now paying a smaller 'contribution II' than previously to get their medicine.
Inclusion in the GHS of products cheaper than the pre-existing ones
If in a category of medicines there are 3 available corresponding formulations in the GHS List of Pharmaceutical Products and in the process a fourth formulation is included, then the order of their classification changes, depending on the price of the formulation that was last included in the System. That is, if the new formulation is cheaper than the formulation which was previously the cheapest and the citizen paid €1 to get it, then the citizen if he continues to take the formulation he was taking previously and does not choose the new one that is cheaper, he will not only pay €1 to get it but will pay the difference in price between the two medicines and therefore will give beyond the supplement (€1) and 'contribution II' equal to the price difference. If he chooses, after consultation with his doctor, to change his formulation and take the cheapest one, then he will continue to pay only €1 as a supplement.
The patent protection period expires
When a formulation is original and the protection time of its patent (patent) expires, usually in a short time from the "break" of the patent, corresponding generic drugs are manufactured, which for the most part are much cheaper than the original and are included in the GHS. As a result, the original formulation, which was reimbursed until the time of the appearance of generic drugs with €1, changed the order in the List of Pharmaceutical Products of its category, and the citizen pays the difference between this and the cheapest generic formulation. That is, if the cheapest generic costs €10 (which the beneficiary gets with €1) and the original €25, then the citizen who previously took the original with €1 will now pay €1 co-payment plus €15 as "contribution II". If he chooses, after consultation with his doctor or pharmacist, to change his formulation and take the cheapest one, then he will continue to pay only €1 as a supplement.
When increasing the number of corresponding drugs in a category
When a formulation for some time was the only one of its category in the GHS List of Pharmaceutical Products and then another company proceeded to the inclusion of its own formulation, which belongs to the same category and is cheaper than the one that existed before, then the medicine that the citizen was receiving, ceases to be available with only € 1 supplement, but the beneficiary procures it by paying the difference in its price, with the price of the medicine that joined the GHS afterwards. That is, if, for example, the first formulation has a price (in the price list of the Ministry of Health) of €10 and the newly admitted to the GHS has a price of €5, the citizen will pay as a "contribution II" €5 and not €1, as he paid previously. If he chooses, after consultation with his doctor, to change his formulation and get the cheapest one, then he will continue to pay only €1 as a supplement.
