ABSTRACT
OBJECTIVES: Since 2010, the memoranda of understanding were implemented in Greece as a measure of fiscal adjustment. Public pharmaceutical expenditure was one of the main focuses of this implementation. Numerous policies, targeted on pharma spending, reduced the pharmaceutical budget by 60.5%. Yet, generics' penetration in Greece remained among the lowest among OECD countries. This study aims to highlight the factors that affect the perceptions of the population on generic drugs and to suggest effective policy measures. METHODOLOGY: The empirical analysis is based on a national cross-sectional survey that was conducted through a sample of 2003 individuals, representative of the general population. Two ordinal logistic regression models were constructed in order to identify the determinants that affect the respondents' beliefs on the safety and the effectiveness of generic drugs. FINDINGS: The empirical findings presented a positive and statistically significant correlation with income, bill payment difficulties, safety and effectiveness of drugs, prescription and dispensing preferences and the views toward pharmaceutical companies. Also, age and trust toward medical community have a positive and statistically significant correlation with the perception on the safety of generic drugs. Policy interventions are suggested on the bases of the empirical results on 3 major categories; (a) information campaigns, (b) incentives to doctors and pharmacists and (c) to strengthen the bioequivalence control framework and the dissemination of results.
Subject(s)
Drug Costs , Drug Prescriptions/standards , Drugs, Generic/standards , Adult , Attitude of Health Personnel , Cost Control , Cross-Sectional Studies , Drug Prescriptions/economics , Drugs, Generic/supply & distribution , Drugs, Generic/therapeutic use , Female , Government Regulation , Greece , Humans , Male , Middle Aged , Surveys and Questionnaires , Therapeutic EquivalencyABSTRACT
Analyses of the medical and economic burden of chronic disorders such as systemic lupus erythematosus (SLE) are valuable for clinical and health policy decisions. We performed a chart-based review of 215 adult SLE patients with active autoantibody-positive disease at the predefined ratio of 30% severe (involvement of major organs requiring treatment) and 70% non-severe, followed at seven hospital centres in Greece. We reviewed 318 patients consecutively registered over three months (sub-study). Disease activity, organ damage, flares and healthcare resource utilization were recorded. Costs were assessed from the third-party payer perspective. Severe SLE patients had chronic active disease more frequently (22.4% vs 4.7%), higher average SLE disease activity index (SLEDAI) (10.5 vs 6.1) and systemic lupus international collaborating clinics (SLICC) damage index (1.1 vs 0.6) than non-severe patients. The mean annual direct medical cost was 3741 for severe vs 1225 for non-severe patients. Severe flares, active renal disease and organ damage were independent cost predictors. In the sub-study, 19% of unselected patients were classified as severe SLE, and 30% of them had chronic active disease. In conclusion, this is the first study to demonstrate the significant clinical and financial burden of Greek SLE patients with active major organ disease. Among them, 30% display chronic activity, in spite of standard care, which represents a significant unmet medical need.
Subject(s)
Lupus Erythematosus, Systemic/drug therapy , Lupus Erythematosus, Systemic/economics , Adult , Autoantibodies/immunology , Female , Greece , Health Care Costs , Humans , Lupus Erythematosus, Systemic/immunology , Male , Middle Aged , Retrospective Studies , Severity of Illness IndexABSTRACT
UNLABELLED: A Greek-specific cost-effectiveness analysis determined the FRAX-based intervention thresholds. Assuming a willingness to pay of 30,000
Subject(s)
Bone Density Conservation Agents/therapeutic use , Osteoporosis/economics , Osteoporotic Fractures/economics , Age Factors , Aged , Aged, 80 and over , Bone Density Conservation Agents/economics , Cost-Benefit Analysis , Drug Costs/statistics & numerical data , Female , Greece/epidemiology , Health Care Costs/statistics & numerical data , Hip Fractures/economics , Hip Fractures/epidemiology , Hip Fractures/prevention & control , Humans , Male , Middle Aged , Models, Econometric , Osteoporosis/drug therapy , Osteoporosis/epidemiology , Osteoporotic Fractures/epidemiology , Osteoporotic Fractures/prevention & control , Risk Assessment/methods , Sex FactorsABSTRACT
Over the recent decades, advances in healthcare technology have led to significant improvements in the quality of healthcare and in population health. At the same time, technological change in healthcare, rising national income and expansion of insurance coverage have been acknowledged as the main determinants of the historical growth in health spending in industrialized countries. The pharmaceutical sector is of particular interest as it constitutes a market characterized by rapid technological change and high expenditure growth rates. The purpose of this article is to provide an overview of research findings on the impact of pharmaceutical innovation on pharmaceutical expenditure growth, total health expenditure and population health outcomes and to bring forward the challenges that arise for pharmaceutical policy in Greece.