MANAGED ENTRY AGREEMENTS (MEAS) IN GREECE: STAKEHOLDER PERSPECTIVES ON OUTCOME-BASED REIMBURSEMENT AND HEALTHCARE SYSTEM READINESS
Author(s)
Ioannis Gasias, MBA, Eglanta Comashi, B.A, Athanassios Vozikis, PhD.
Laboratory of Health Economics & Management (LabHEM), University of Piraeus, Piraeus, Greece.
Laboratory of Health Economics & Management (LabHEM), University of Piraeus, Piraeus, Greece.
OBJECTIVES: To assess Greek stakeholder perspectives on the maturity of Managed Entry Agreements (MEAs), readiness for outcome-based reimbursement, implementation barriers, and priorities for healthcare-system preparedness.
METHODS: A cross-sectional survey of fifteen high-level stakeholders representing the pharmaceutical industry, HTA/assessment bodies, academia/health economics, patient organizations, public payer/EOPYY, Ministry of Health, IDIKA, medical/scientific societies, and the negotiation committee was conducted. Responses were summarized using descriptive statistics, while open-ended responses were reviewed thematically to identify common policy priorities and implementation challenges
RESULTS: The Greek MEA framework was perceived as immature (mean maturity score: 2.27/5; median: 2), while its contribution to sustainable expenditure management was rated as moderate to low (mean score: 2.60/5). MEAs were primarily perceived as budget-control instruments (60%) or cost-containment mechanisms (40%). Readiness for outcome-based reimbursement was considered limited (mean score: 2.60/5). Despite this, respondents expressed strong expectations regarding the future role of real-world evidence (mean score: 4.47/5; 60% considered it essential) and acknowledged the importance of the Innovation Fund (mean score: 3.80/5). The most frequently reported barriers included immature governance frameworks, lack of patient registries, and limited data interoperability (47% each), followed by workforce constraints (40%) and inadequate data quality (33%). Oncology emerged as the preferred area for pilot implementation (100%), followed by rare diseases (47%) and hematology (40%). Sixty percent of stakeholders reported more than ten years of experience in healthcare policy, reimbursement, or market access.
CONCLUSIONS: These findings suggest that Greece is entering a transitional phase in which MEAs are increasingly viewed not only as fiscal-control instruments but also as potential enablers of value-based access to innovation. Achieving this transition will require investment in patient registries, real-world evidence generation, interoperability, and transparent governance structures
METHODS: A cross-sectional survey of fifteen high-level stakeholders representing the pharmaceutical industry, HTA/assessment bodies, academia/health economics, patient organizations, public payer/EOPYY, Ministry of Health, IDIKA, medical/scientific societies, and the negotiation committee was conducted. Responses were summarized using descriptive statistics, while open-ended responses were reviewed thematically to identify common policy priorities and implementation challenges
RESULTS: The Greek MEA framework was perceived as immature (mean maturity score: 2.27/5; median: 2), while its contribution to sustainable expenditure management was rated as moderate to low (mean score: 2.60/5). MEAs were primarily perceived as budget-control instruments (60%) or cost-containment mechanisms (40%). Readiness for outcome-based reimbursement was considered limited (mean score: 2.60/5). Despite this, respondents expressed strong expectations regarding the future role of real-world evidence (mean score: 4.47/5; 60% considered it essential) and acknowledged the importance of the Innovation Fund (mean score: 3.80/5). The most frequently reported barriers included immature governance frameworks, lack of patient registries, and limited data interoperability (47% each), followed by workforce constraints (40%) and inadequate data quality (33%). Oncology emerged as the preferred area for pilot implementation (100%), followed by rare diseases (47%) and hematology (40%). Sixty percent of stakeholders reported more than ten years of experience in healthcare policy, reimbursement, or market access.
CONCLUSIONS: These findings suggest that Greece is entering a transitional phase in which MEAs are increasingly viewed not only as fiscal-control instruments but also as potential enablers of value-based access to innovation. Achieving this transition will require investment in patient registries, real-world evidence generation, interoperability, and transparent governance structures
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HPR89
Topic
Health Policy & Regulatory, Health Technology Assessment, Patient-Centered Research
Topic Subcategory
Reimbursement & Access Policy, Risk-sharing Approaches
Disease
No Additional Disease & Conditions/Specialized Treatment Areas