Social security funds bound up in red tape

Private spending on medicines, including contributions by social security insurees, comes to over 710 million euros a year, absorbs 38.4 percent of total expenditure on drugs, and accounts for 15.2 percent of the overall expenditure on health. The amount of private spending on drugs is an issue that emerged from recent research by Kyriakos Souliotis and Vassilis Kontozamanis. Changes in the pricing system in 1997 coupled with a stipulated list of prescriptions resulted in only a temporary drop in pharmaceutical spending, which continued to rise, affecting private spending on medicines as well. «In 2001,» Kontozamanis notes, «the market turnover in medicines increased by 22 percent over 2000, with 15 percent due to new drugs entering the market. This development is the result of reforms by the central administration in 1997, as well as advances in research and the manufacture of pioneering drug treatments, which meet the requirement of cost-effectiveness.» It is necessary, he went on to say, to study the overall cost and benefit of treatment for a disease, and less the additional cost incurred from the emergence of a new drug on the market, so as to determine the best choice for a health policy. «It’s a fact,» said Kyriakos Souliotis, «that private expenditure on drugs is very high and follows the corresponding rise in private expenditure on healthcare. I feel that the ‘time cost’ arising from the labyrinthine procedures of the social security funds is the nub of the matter. People often choose to buy medicines at their own expense as a result.» But he stressed that before the findings on the rise in private and general pharmaceutical spending in Greece are made public, research should be carried out into another issue, namely the substitution of pharmaceutical for hospital care, well known in international treatises on the subject. «This substitution, as an automatic mechanism, seems to be the case in Greece as well, basically due to the directness of access, without any accompanying procedures.»