OBJECTIVES: Entering the fiscal adjustment program in 2010, one of the primary mandates for Greece was to reduce public pharmaceutical expenditure from the then current 2.2% of GDP to 1%. Within this context, a series of policies (increased copayments, price-cuts, delisting, rebates, clawbacks etc) were enforced. As a result, 2014 public pharmaceutical expenditure did reach 1% of GDP, but following a significant increase in private spending. In this light, the purpose of this study is to investigate the macroeconomic trends in pharma expenditure during 2009-2014 and estimate the public/private mix of contributions. METHODS: Aggregate data on outpatient sales by the Greek National Medicines Agency for 2009-2014, formed the basis of the analysis. To account for price changes, expenditures were adjusted to 2014 constant prices, by estimating and using the weighted average price/box for 2014 as deflator. Expenditures were allocated to public or private payers according to official macroeconomic reports of the third-party payers for 2009 and via publicly available subaccounts for 2014. RESULTS: Pharmaceutical expenditure totaled 6.12 billion euros in 2009 (€5.1 billion public, €0.09 billion rebates, €0.91 billion private) and €3.57 billion in 2014 (€2 billion public expenditure, €428 million in rebates/clawbacks, €1.14 billion private). Average price per box sold fell by 36.2% during 2009-2014. Thus, when adjusting for prices, the respective figures are €3.90 and €3.57 billion. Public/private mix was 85%/15% for 2009 and 64%/36% for 2014 (excluding rebates). A total of a €0.93 billion shift towards patients and companies (€564million towards patients and €366million as additional rebates/clawbacks) resulted in achieving the fiscal target of 1% of GDP for 2014 public pharma expenditure. CONCLUSIONS: Despite the rhetoric and the reforms implemented, total outpatient pharmaceutical volumes dropped by only 8% during 2009-2014. Fiscal adjustment was achieved by cost-shifting to private payers, primarily to patients, raising concerns about equity in access and social solidarity.