OBJECTIVES: Within the context of the recent pharmaceutical policy reforms in Greece, the price of generics have been steadily an issue of concern. Based on a cross-sectional analysis by IQVIA, regarding the average nominal price of generic medicines in different EU countries, this study updates a previous assessment of the average price of generics in Greece compared with other EU countries, after controlling for possible mandatory paybacks, i.e. rebates and clawbacks, a feature that falls beyond the scope of the IQVIA analysis.

METHODS: Data from the IQVIA “Market Trends Q1/2019” analysis were used, comparing the generics market penetration and their average ex-factory price per standard unit in 18 EU countries. Information regarding paybacks were elicited by literature references and were updated with data from official websites and legislation in each country. Additionally, the latest June 2018 re-pricing in Greece was considered.

RESULTS: Generics were not subject to paybacks in 11 out of 18 EU countries. In the remaining countries paybacks ranged from 1% (Spain) up to 20% (Hungary). In Greece paybacks amounted to 36.6% over the ex-factory price (2017: 33.5%). The generics’ average ex-factory price after controlling for paybacks was 0.098€ per standard unit (2017: 0.104 €). This ranks the price level of generics in Greece as the fourth lowest amongst the countries compared. In parallel, Greece continues to mark the lowest generics penetration amongst the countries compared (Greece :34.1% vs EU countries unweighted average:57.6%)

CONCLUSIONS: Paybacks in Greece are the highest among the EU countries. This has an indirect -but nevertheless true- negative effect at the net ex-factory prices of generics which may hinder their market availability, contradicting with the target to increase their penetration. Cross-sectional price comparisons taking into account the possible paybacks, would provide useful insights over the implementation of pricing policies at the European level.