Viable, Patient-Centered Healthcare

Haseeb Ahmad, Managing Director of MSD Greece, Cyprus and Malta, discusses key policy imperatives for Greece’s healthcare system.

What are the main issues the pharmaceutical industry in Greece faces today?

The pharmaceutical industry in Greece is about to face the impact of the austerity policies of the 3rd bailout agreement. Nevertheless and although the government arrears to the pharmaceutical industry exceed 1.2 billion Euros, the industry will contribute about 600 million Euros in 2015 in clawbacks and rebates for the government to reach its spending targets.

One of the most important adverse provisions of the new memorandum is that the public pharmaceutical budget has been set at the annual target of 1.94 billion Euros for the next three years. This is 60% lower than 2009, so from the high levels of 2009 we are now reaching the other end of the pendulum, that of the severe underfinancing of healthcare in Greece. This budget will have to accommodate the increasing costs of the uninsured population, the impact of the austerity policies on a population with deteriorating health, and the need to reimburse new medicines for life-saving conditions. It is difficult to maintain a decent level of healthcare provision unless we become more efficient and increase the pharma budget.

Moreover, recent political and economic instability has increased the uncertainty of our operational environment and companies cannot effectively or reliably plan their investment activities. Given that health care is a significant factor for growth in the Greek economy (1 Euro spent in health care brings almost another 7 in the real economy), both the reduction in health spending and the economic, political and social uncertainty are discouraging investments and innovation, key prerequisites for economic development and job creation. We must work together with all stakeholders to ensure that this 3rd bailout agreement period will establish a sustainable, efficient, effective and patient-centered health care system that will improve health outcomes for the whole of the population.

What steps are needed to achieve higher efficiency and sustainability in pharmaceutical policy?

The first step is to accept that we need change. We must think out of the box, implement innovative solutions and learn from the experience of others so that we do more with less.

MSD has proposed A Roadmap Towards a Health Care System, which will provide higher value per Euro spent. Our focus will be to establish national health priorities, i.e. diseases which impact the health levels of large parts of the population or impose a high financial burden to health care payers. With a national health policy plan we can address the adverse health consequences of these diseases and maximize health outcomes.

Second, we must fully exploit the e-prescription platforms already developed in HDIKA and EOPYY to effectively monitor patient outcomes and build a capacity to assess the value of health care and pharmaceutical interventions. Greece can become a World Wide Excellence Center for Observational Research and through collaborations with the scientific leaders, Greece can become competitive and attract significant investments in phase III and phase IV trials.

Third, we must focus on assessing the value for our money and not solely the cost of what we pay. To this end we must establish effective health technology assessment mechanisms which will transparently and fairly provide the appropriate information to payers, physicians and patients to make rational reimbursement and prescribing decisions. Our current reimbursement system does not take the value of medicines into account. On the contrary, the jumble of ATC-IV based clusters of products leads to very low reimbursement prices and heavy additional prescription fees for patients or rebates for pharma companies. We must proceed with an ATC–V based reimbursement system with protocols defining the appropriate prescribing choices monitoring e-prescribing. In clusters with generics, clever reimbursement prices for generics could significantly increase their penetration, reducing overall patient fees and health care inequities.

Fourth, we need to focus on increasing patient participation in the decision process and invest in networks, data monitoring and data mining, new analytics, and new forms of patient management, which lead to improved patient outcomes and reduced costs.

As a Chairman of the AMCHAM Committee that represents a number of pharmaceutical companies, how do you view the contribution of the pharmaceutical sector to the Greek economy during the crisis—and what should we expect?

Throughout the crisis, pharmaceutical companies, members of AMCHAM, continued providing medicines, especially life-saving medicines, to ensure public health safety.

Moreover, according to IOVE, their contribution to GDP remains high, reaching € 7,5 billion. The economic footprint of production and distribution of pharmaceutical products is strong, resulting in more than 132,000 jobs. Pharmaceuticals are responsible for 22 % of R&D spending in Greece, paving the way for innovative treatments, and the pharma sector is 4th in exports. Its production rate is the 7th highest in terms of domestic processing.

The pharmaceutical sector has proven that it plays an important role in national wealth and health. Health, in the context of the Lisbon Strategy 2005, is a precondition to achieve economic growth and increases productivity and labor supply.

At AMCHAM we believe we need a strong, Greek-based pharma sector and a strong multinational, research-based innovative industry that can become an even more important economy driver. We want to initiate and encourage partnerships between government, academia and industry to increase the level of innovation in the Greek health care system.

Which is the MSD footprint in Greece?

At MSD Greece we have a vision: leading the way to improve lives in Greece, through our innovative medicines and through supporting the Greek economy.

We are a research-based pharmaceutical company, operating in 140 countries with over 160 years of discovering and developing new therapies that improve peoples’ lives. Our portfolio includes new antibiotics that can tackle antimicrobial resistance, new oncology drugs to fight deadly tumors across many cancer types and new medicines against Alzheimer’s. MSD in Greece is expected to soon bring new innovative therapies in Immuno-oncology, diabetes, cholesterol treatment, hepatitis C and antibiotics.

MSD has a strong footprint in the Greek economy; approximately half of the volume of our products sold in Greece are locally produced and packaged, valued at over € 40 million a year. With our CSR programs and through our partnership with the Athens University of Economics and Business, 22 young entrepreneurs have turned their innovative ideas to real business. And we were awarded as the 4th company in the Best Workplace 2015 competition. We believe that the only way to help people be well is by first ensuring the wellbeing of our employees.

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