The Greek government and the pharmaceutical industry are in advanced discussions on a potential three-year framework agreement aimed at creating a more stable and predictable environment for the sector. These talks come as Greece grapples with soaring clawback and rebate payments, which have increasingly strained the industry. The framework is expected to launch in early 2025 and forms part of a broader effort to modernise the country’s healthcare system, according to recent reports from Greek media outlets HealthReport and News4Health.
Key players in the pharmaceutical industry, including the Pharmaceutical Research and Manufacturers of America (PhRMA) Innovation Forum (PIF) and the Hellenic Association of Pharmaceutical Companies (SFEE), have presented proposals to the Ministry of Health (MoH) to address these mounting challenges. Both groups have advocated for the establishment of a Pharmaceutical Innovation Fund, or a transitional reimbursement scheme, to provide much-needed resources for new treatments entering the Greek market. This would include horizon scanning, separate funding from the main pharmaceutical reimbursement budget, and a transition to a standard reimbursement system over time.
Aris Aggelis, the MoH’s Secretary General for Strategic Planning, confirmed that the government plans to pilot a pharmaceutical innovation fund by March 2025, with a full rollout later in the year. The fund, supported by both public financing and industry contributions, aims to give patients faster access to innovative treatments while maintaining the long-term sustainability of Greece’s healthcare system. Health Minister Adonis Georgiadis echoed these sentiments at the HealthWorld conference in September, stating that both the government and the pharmaceutical industry are aligned on the need for a framework agreement, which could be finalized by year-end.
However, the discussions are overshadowed by the impending expiration of the current clawback mechanism in 2025, a controversial policy that was originally introduced to address the aftermath of Greece’s sovereign debt crisis. Although it was meant to be temporary, the clawback system has been extended several times and has placed a significant financial burden on pharmaceutical companies. In 2020, clawback payments amounted to €1.97 billion, a figure that surged to €3.51 billion by 2023. The government has been forced to rely on EU Recovery and Resilience Facility (RRF) funds to partially offset these costs, but industry leaders argue that this is not a sustainable solution.
The primary issue driving the ballooning clawback payments is that Greece’s pharmaceutical reimbursement budget has remained virtually unchanged since 2014, while the demand for new, often expensive, therapies continues to rise. As a result, pharmaceutical companies supplying Greek hospitals are now liable for as much as 83% of spending on certain hospital drugs.
Looking ahead, success in implementing the proposed Pharmaceutical Innovation Fund or framework agreement will likely depend on the government’s willingness to significantly increase the pharmaceutical reimbursement budget. In 2024-2025, the government has committed to adding €850 million to the budget, but industry leaders argue that this is insufficient to cover the current clawback liabilities. Moreover, any new fund for innovative therapies must remain distinct from the main budget to provide meaningful support for emerging treatments.
With the clawback mechanism set to expire and negotiations still ongoing, the road ahead for the pharmaceutical industry in Greece remains uncertain. The outcome of these talks will have significant implications not only for pharmaceutical companies but also for the broader healthcare system as Greece seeks to balance innovation with financial sustainability.
