Negotiated Closed Budgets in Greece: A Case Study of Success in Enhancing Patient Access Whilst Achieving Savings
Author(s)
Nandia Gogozotou, MBA, MSc, PharmD, PhD1, Elisavet Komnineli, MBA, MSc, PharmD1, Anastasia Seimeni, MSc, PharmD1, CHRISTINA ALEXANIAN, PharmD, MSc1, CHRISTINA GOLNA, LLM, MSc2, Kyriakos Souliotis, PhD3.
1Drug Price Negotiation Committee, Ministry of Health, Athens, Greece, 2Health Policy Institute, Maroussi, Greece, 3School of Social and Political Sciences, University of Peloponnese, Corinth, Greece.
1Drug Price Negotiation Committee, Ministry of Health, Athens, Greece, 2Health Policy Institute, Maroussi, Greece, 3School of Social and Political Sciences, University of Peloponnese, Corinth, Greece.
Presentation Documents
OBJECTIVES: Closed budgets of a duration of up to two years can be negotiated between the Drug Price Negotiation Committee (DPNC) of the Ministry of Health and pharmaceutical companies (Marketing Authorization Holders, MAHs) in Greece. We aimed to assess the impact of negotiated closed budgets on levels of use and cost to the public pharmaceutical budget of adalimumab, lenalidomide and abiraterone & apalutamide in Greece.
METHODS: We utilized data from the DPNC database and other publicly available sources. We calculated the increase in units used in each year of the negotiated budget being in place as well as the difference in costs, after allowing for statutory paybacks. Cutoff date for comparisons was May 25, 2025. Results are presented as percentages versus baseline year (last year without negotiated budget). All costs are in euros of the year to which they refer.
RESULTS: Compared to the last year without a negotiated budget (2019), by cutoff date adalimumab use in units (syringes and pens) had increased by a cumulative 164.2% at an additional cost for the state pharmaceutical budget of a mere 14.5%. For lenalidomide, an increase of 52.5% in units between end 2020 (no negotiated budget) and cutoff date was accompanied by a 63.5% reduction, i.e., saving, in the state pharmaceutical budget. Finally, in the per os therapies for prostate cancer (abiraterone & apalutamide), which were negotiated at the therapy area level, a cumulative increase of 204.9% in units between end 2021 (no negotiated budget) and cutoff date led to a modest increase in the state budget of 28.6%.
CONCLUSIONS: Closed budgets agreed after negotiation between the Drug Price Negotiation Committee and MAHs in Greece are a proven success story of ensuring widest possible access for patients in need at substantial savings for the state pharmaceutical budget.
METHODS: We utilized data from the DPNC database and other publicly available sources. We calculated the increase in units used in each year of the negotiated budget being in place as well as the difference in costs, after allowing for statutory paybacks. Cutoff date for comparisons was May 25, 2025. Results are presented as percentages versus baseline year (last year without negotiated budget). All costs are in euros of the year to which they refer.
RESULTS: Compared to the last year without a negotiated budget (2019), by cutoff date adalimumab use in units (syringes and pens) had increased by a cumulative 164.2% at an additional cost for the state pharmaceutical budget of a mere 14.5%. For lenalidomide, an increase of 52.5% in units between end 2020 (no negotiated budget) and cutoff date was accompanied by a 63.5% reduction, i.e., saving, in the state pharmaceutical budget. Finally, in the per os therapies for prostate cancer (abiraterone & apalutamide), which were negotiated at the therapy area level, a cumulative increase of 204.9% in units between end 2021 (no negotiated budget) and cutoff date led to a modest increase in the state budget of 28.6%.
CONCLUSIONS: Closed budgets agreed after negotiation between the Drug Price Negotiation Committee and MAHs in Greece are a proven success story of ensuring widest possible access for patients in need at substantial savings for the state pharmaceutical budget.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HPR149
Topic
Economic Evaluation, Health Policy & Regulatory, Health Technology Assessment
Topic Subcategory
Reimbursement & Access Policy
Disease
No Additional Disease & Conditions/Specialized Treatment Areas