PROCUREMENT AND EXPENDITURE TRENDS OF ORPHAN AND NON-ORPHAN HIGH-COST MEDICINES DISPENSED THROUGH PUBLIC OUTPATIENT PHARMACIES IN GREECE, 2020-2025
Author(s)
Panagiotis Paterakis, PharmD, MSc, PhD1, Christina Georgi, PharmD, MSc, PhD1, Elisavet Komnineli, MBA, MSc, PharmD2, Nandia Gogozotou, MBA, MSc, PharmD, PhD1.
1National Organization for Healthcare Services Provision (EOPYY), Athens, Greece, 2Greek Ministry of Health, Athens, Greece.
1National Organization for Healthcare Services Provision (EOPYY), Athens, Greece, 2Greek Ministry of Health, Athens, Greece.
OBJECTIVES: In Greece, EOPYY public outpatient pharmacies are the main distribution channel for high-cost medicines, including reimbursed therapies listed in official price bulletins and imported medicines made available through the electronic pre-authorization system. These medicines are dispensed without patient co-payment. This study assessed trends in acquisition volumes and expenditure for orphan and non-orphan medicinal products dispensed through EOPYY pharmacies during 2020-2025.
METHODS: Aggregated data were extracted from EOPYY pharmacy invoice records and analyzed. Key indicators included the number of distinct proprietary medicinal products, total pharmaceutical packages procured, and acquisition expenditure, analyzed separately for orphan and non-orphan medicines. Products were classified as orphan on a yearly basis if they held an EMA orphan designation for at least one indication at any point during the respective year.
RESULTS: Between 2020 and 2025, the number of distinct non-orphan drug names increased from 450 to 584 (+29.8). Total pharmaceutical packages rose from 3.00 million to 4.04 million (+34.5%), while acquisition expenditure increased from €1.48 billion to €2.44 billion (+64.3%). Average acquisition cost per package increased from €493 to €604 (+22.5%). For orphan medicinal products, the number of distinct trade names remained relatively stable (50-54), while total packages decreased from 115,974 to 52,472. Despite lower volumes, expenditure increased from €174.7 million to €246.5 million (+41.1%), with average acquisition cost per package rising from €1,507 to €4,698 (+211.7%). Consequently, the orphan to non-orphan cost ratio per package increased from 3.1 to 7.8.
CONCLUSIONS: Pharmaceutical expenditure evolved differently between orphan and non-orphan medicines. Expenditure growth for non-orphan medicines was associated with increasing product availability and utilization, whereas orphan medicines exhibited rising expenditure despite stable product availability and lower volumes. This divergence suggests that factors beyond utilization are contributing to expenditure growth and highlights the importance of monitoring the budget impact of innovative therapies.
METHODS: Aggregated data were extracted from EOPYY pharmacy invoice records and analyzed. Key indicators included the number of distinct proprietary medicinal products, total pharmaceutical packages procured, and acquisition expenditure, analyzed separately for orphan and non-orphan medicines. Products were classified as orphan on a yearly basis if they held an EMA orphan designation for at least one indication at any point during the respective year.
RESULTS: Between 2020 and 2025, the number of distinct non-orphan drug names increased from 450 to 584 (+29.8). Total pharmaceutical packages rose from 3.00 million to 4.04 million (+34.5%), while acquisition expenditure increased from €1.48 billion to €2.44 billion (+64.3%). Average acquisition cost per package increased from €493 to €604 (+22.5%). For orphan medicinal products, the number of distinct trade names remained relatively stable (50-54), while total packages decreased from 115,974 to 52,472. Despite lower volumes, expenditure increased from €174.7 million to €246.5 million (+41.1%), with average acquisition cost per package rising from €1,507 to €4,698 (+211.7%). Consequently, the orphan to non-orphan cost ratio per package increased from 3.1 to 7.8.
CONCLUSIONS: Pharmaceutical expenditure evolved differently between orphan and non-orphan medicines. Expenditure growth for non-orphan medicines was associated with increasing product availability and utilization, whereas orphan medicines exhibited rising expenditure despite stable product availability and lower volumes. This divergence suggests that factors beyond utilization are contributing to expenditure growth and highlights the importance of monitoring the budget impact of innovative therapies.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HPR161
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care, Real World Data & Information Systems
Topic Subcategory
Public Spending & National Health Expenditures
Disease
No Additional Disease & Conditions/Specialized Treatment Areas