Is the medicines expenditure at 20%of total healthcare expenditure the only culprit for staggering healthcare expenditure?
Healthcare Expenditure as % GDP (OECD Average & Greece)
Challenges of Greek ESY- National Healthcare System• Socio-economic & demographic factors• Reduction of public financing resulting in quality deterioration of public healthcare sector• 35 mandatory social insurance funds for healthcare and pension• Steady increase of private payments for healthcare• Increased dependence on private healthcare sector• Access and disparities problems• Low satisfaction of patients from public healthcare system• Excesses & bad practices in medicines prescribing & referrals• Absence of a central reliable healthcare supply system
Situation aggravated by..• lack of audit, measurement & evaluation of healthcare services• lack of modern accounting & MIS in all healthcare system• no interoperability of systems• absence of health information technology• uncontrolled & overpriced purchases of medical equipment & supplies• high expenditure on medicines• no state control in the distribution channels of medicines• no real price reduction between original & generic medicines
MoU between Greece, IMF, ECT, EURequirements• Reduce & maintain total public healthcare expenditure lower or equal to 6% of GDP• Reduce public expenditure of medicines by 2 b. euro till 2012, while 1b. euro should recovered within 2011• Public expenditure of medicines = 1% of GDP
Measures taken• Introduction of an e-prescribing & e-referral app• Introduction of DRGs• Establishment of the Prices Observatory for Healthcare PurchasesBut a lot more has not been done or has beenrelayed for after the elections for fear of politicalcost…..
What’s at stake?Public Healthcare Outcomes! Measures aimed solely at expenditurereduction not at quality health outcomes
How measures were taken?After strikes & negotiations with healthcare interestgroups e.g. physicians, pharmacists, pharma,nurses…. Have the key stakeholders been consulted? Who are they? PATIENTS of course!! Patients in Greece ARE NOT a key healthcare stakeholder
THANK YOU FOR YOUR ATTENTION! Kathi Apostolidis -@kgapo Breast Cancer & Patient Rights Advocate Voluntary Sector Consultant-Health Commentator Engage 2011-Nov 28, 2011, Brussels