OBJECTIVES: Recent pricing regulation in Greece provides that generics are priced at 65% of price of the reference off-patent while off patents are priced at the minimum between a decrease of 50% of their latest on -patent price, and the average of the three lowest prices of the same product among the 27 EU member states. The purpose of this study is to assess the price level of generics atorvastatin in Greece.

METHODS: Official pricing data were used to identify the three EU member states which set the outpatient market price for off-patent atorvastatin 20mg and 40 mg in Greece in December 2016. The ex-factory prices for the originator and generics in each of the EU countries were derived from the official price source in each setting. All prices were normalized to correspond to monthly treatment.

RESULTS: Average ex-factory price for generic atorvastatin 20mg in Greece (2.68€) were 40.18% lower than the price in Croatia (4.48€), 51.45% lower than Belgium (5.52€) and 52.73% lower than Luxemburg (5.67€). Average ex-factory price for generic atorvastatin 40mg in Greece (3.97€) were 6.99% higher than the price in Slovenia (3.71€), 13.97% lower than Bulgaria (4.61€) and 46.43% lower than Croatia (7.41€).

CONCLUSIONS: Average ex-factory price for generic atorvastatin in Greece is up to 52.73% below the respective generic prices at the EU countries with the lowest price of the reference originator. With rebates and clawback considered the average generic atorvastatin ex-factory price in Greece is further reduced by 30% approximately (for 2016). However, despite the excessively low generic price levels, current penetration (~25%) lacks behind the MoU target of 40% by volume for 2017, suggesting the need of a reasonable pricing regulation allowing viability for generics in parallel with demand side measures to enhance the use of generics through appropriate incentives for physicians, pharmacists and patients.