FROM THE ECONOMIST INTELLIGENCE UNIT
Greece's austerity measures are once again hitting the country's pharma industry, as cost-containment tightens.The pain is far from over for pharma companies in Greece, as new cost-containment measures for the sector come into force. As part of its efforts to cut spending in the wake of its latest EU bailout, parliament has passed a new law limiting drug spending by the country's social insurance funds to ˆ2.88bn (US$3.8bn this year. The industry itself will be liable for any overspend.
The new law also makes it a criminal offence for doctors to prescribe drugs by brand rather than generic name. This draconian measure will apply to the top ten therapeutic classes from April 1st, and then to all drugs on the reimbursement list from June 1st. The country's reimbursement scheme will only cover the generic cost, with any additional cost to be covered by the patient. In addition, doctors will be fined if they fail to prescribe via the new electronic prescription system, while pharmacy opening hours will be extended.
The aim of these measures is to slice ˆ1bn off the country's drugs bill this year.
In December 2011, while Greece was negotiating its latest bailout, the EU and IMF reportedly asked for drug spending to be reduced to 1% of GDP. The Greek National Organisation for Medicines declared this goal was unrealistic. If the latest measures do succeed in cutting spend to ˆ2.88bn, then that will amount of around 1.4% of Greece's projected ˆ199bn in GDP this year.The government also wants to raise the market share of generic drugs, which is currently one of the lowest in Europe at around 16% by volume in 2009, according to the
European Federation of Pharmaceutical Industries and Associations . Critics attribute this low share to the minimal difference between generic and branded drug prices, as well as incentives in the pharmacy sector which favoured more expensive drugs. The government has already moved to limit pharmacy profit margins to a flat fee, a measure that is expected to cut the number of pharmacies by 30% over the next few years.These and other measures have already proved highly controversial. In May 2010, in the wake of previous austerity measures, pharma prices were cut by a weighted average of 21.5%, prompting protests from pharmaceutical producers. Two Danish pharmaceutical companies, Novo Nordisk and Leo Pharma, withdrew a number of their products from the Greek market (they reversed this action only after the government eased the price-cuts slightly .
Despite this, the government introduced a new referencing pricing system in September aligning Greek prices with the average of the three lowest-priced EU countries. The effect was to cut prices by a further 20%.
As a result, Greece now has some of the lowest pharma prices in Europe, a fact that has prompted a huge parallel trade with other EU markets. Moreover, many hospitals have failed to pay for the drugs they have received, with debts to pharma companies deepening every month.This latest announcement will lead to more controversy and further deter launches in the pharma sector. The government is clearly prepared for that, however. According to Pharma Times, ministers have in any case been contemplating banning new drug launches until such drugs have been accepted for reimbursement in 8-10 other EU countries. Though that measure would probably exclude cancer drugs, the main losers would be Greek patients.
Greece's parliament has passed major new pharmaceutical cost-containment legislation which will require drugmakers to cover, each quarter, any overspending on the strict limits which the bill sets for the national drugs bill.
The new law - which passed on a 213-58 vote, with a number of deputies abstaining - states that overall drugs spending by Greece's social insurance funds must not exceed 2.88 billion euros for this year.
The legislation also mandates that, from April 1, clinicians must prescribe medicines from the 10 most-widely used therapeutic classes by generic name only, and from June 1 this requirement will apply to all products on Greece's positive reimbursement list. The funds will reimburse at the level of the cheapest product in each class, and any cost difference between this and the product supplied will have to be paid for by the patient.
Moreover, "inappropriate" prescribing - ie, of medicines by other than their generic name, and not of the cheapest product available - will now be classed as a criminal offence, according to local reports.
Generics currently account for just 18% of the pharmaceutical market in Greece, one of the lowest levels in the European Union (EU , and the latest measures aim to bring this up to the EU average of 50%. Health Minister Andreas Loverdos - who says he intends to slice a massive one billion euros off the nation's drug spending in a single year - has condemned a "coalition of interests" for allegedly attempting to cast doubts on the quality and safety of generics with the aim of hindering their wider uptake in Greece; however, counterfeit drugs are a significantly greater problem for Greece than for other EU nations.
The new law also seeks to save money by mandating the use of computerised prescriptions, with the imposition of a 1-euro fine on doctors for each hand-written prescription, and deregulation of pharmacy opening hours.
The legislation constitutes a requirement by the EU, the European Central Bank (ECB and the International Monetary Fund (IMF - Greece's "troika" of creditors - for agreeing a second bailout of 130 billion euros for Greece.
It is also reported that Yiannis Tounta, president of Greece's National Organisation of Medicines (EOF has been in talks with the troika concerning moves to delay the introduction into Greece of innovative new medicines until the products have been accepted for reimbursement by 8-10 other EU member states. Cancer drugs would be excluded from the proposals.
Commenting on the new legislation, analysts at IHS Global Inslght say that the requirement for pharmaceutical companies to pay back any spending above the stated limit in each quarter is "very negative." This is especially so given that many multinational and Greek drugmakers are owed considerable amounts, by the public hospitals in particular, and that the multinationals which have been paid in Greek government bonds have seen their value plummet, they note.
• A number of decrees concerning implementation of some of the major measures contained within the cost-containment legislation are expected to be announced shortly.
Anonymous group launches online platform for leaks
News
Erin Hudson — The McGill Daily (McGill University
MONTREAL (CUP — Documents from McGill’s Development and Alumni Relations (DAR , many of which are marked “confidential” or “highly confidential,” were posted online on March 3 by the anonymous group McGillLeaks.
In a statement on its website,
McGillLeaks announced its intention to release hundreds of documents over the next three weeks, starting with the release of DAR documents pertaining to pharmaceutical, biotechnology and defence industries. The documents can be downloaded from the McGillLeaks website.
The first release of documents contains donor and corporation profiles, correspondence pertaining to corporate funding, histories of corporate donations and relations, and industrial partnerships — notably, a Memorandum of Understanding between McGill and Canadian pharmaceutical company GlaxoSmithKline Inc.
On its website, DAR states that its “many programs and activities help the University establish and maintain strong relationships with alumni, donors, and potential donors.” DAR employees report to vice-principal (development and alumni relations Marc Weinstein.
In its statement, McGillLeaks verified the authenticity of the documents on its website and stated that the contents of the documents have not been altered.
McGillLeaks outlines three goals for its public release of the documents: to provide an account of a “corporate university’s inner workings,” to supply accurate information regarding McGill’s relations with the private sector and to create transparency.
“While not exhaustive in any sense, the documents are primary source material on the university’s role within the competitive market, and how it conceives of that role,” the statement reads. “We are cognizant of the fact that the methods used by McGill are similar to those of many other ‘public research universities,’ and thus are relevant not only to those with an interest in McGill,” it continues.
The university has a
policy regarding safe disclosure in recognition of the “necessary and valuable service” of the “good faith reporting of improper activities ('whistleblowing' ." The policy, approved in 2007, applies to all members of the McGill community, and such reports will not be considered cause for reprisal.
Under the policy, an improper activity is “an act or omission committed by a [member of the university community] that constitutes ‘Academic Misconduct,’ ‘Research Misconduct,’ or ‘Financial Misconduct.’”
The policy also states that, in all McGill activities, the university “seeks to promote a culture based on honest, transparent, and accountable behaviour.”
It is unknown whether the safe disclosure policy would apply to McGillLeaks.
In its statement, McGillLeaks discusses its “leak” of documents. “We do not see the leak and the new level of transparency it produces as ends in themselves. These documents are only as important as your pursuant critical analysis and initiative,” the statement reads.
McGillLeaks states it will publish submissions of documents related to McGill that are “classified, confidential, and/or not yet public.” The group advises any contributions to be made anonymously and advises against contacting the group from the McGill network.
When contacted March 5, the McGill administration was not aware of the existence of the site. The
Daily
is currently waiting for a comment from the university.
This story will be updated online as new information comes to light.
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