Last update:
09-Mar-2021

The accelerated rate of pharmaceutical innovation and the resulting increase in pharmaceutical spending constitute a challenging problem for the health administration and its policy, and for the scientific community. In Greece, in particular, since budgetary surveillance was imposed on Greece, because of the absence of an appropriate infrastructure for negotiations on reimbursed prices (a structure that would have the ability to control and restrict pharmaceutical spending), an upper obligatory budget limit on pharmaceutical public spending has been legally established. The legally established upper limit has been implemented through two obligatory infrastructures, the volume discounts (rebate) in the first place, and ultimately the automatic returns adjustments (claw back). It is a common, publicly declared estimate that the level of the legally established upper limit to public pharmaceutical spending is quite low, given the needs of the Greek population. Hence, the resulting level of automatic returns has been quite high for the pharmaceutical industry. The main aim of this paper is to contribute to a much-needed public debate about the adequate level of the upper limit of public pharmaceutical spending, adjusted to the population needs, along with fairer distribution of the claw back, while the need for an upper limit is present, with breakdown of this upper limit into an ATC4 multi-level, and with population needs defined more accurately.

Key words: ATC categorization, Mandatory automatic returns (claw back), Public pharmaceutical expenditure.