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General and Risk Management, Patient Safety (including: medication errors, quality control)
Critical appraisal of a new medicines pricing policy in Greek hospitals
  1. K. Nikou,
  2. K. Perdikouri
  1. 1General Hospital of Chest Diseases ‘Sotiria’, Pharmacy, Athens, Greece
  2. 2Spiliopoulio Hospital, Pharmacy, Athens, Greece


Background A new regulation has recently given Greek hospital pharmacists the right, through local medicines committees, to directly negotiate medicines prices with the suppliers, instead of using the official prices.

Purpose The aim of this report is twofold: primarily to review the first financial benefits deriving from the new procedure and second to highlight some points that should be considered when evaluating the whole process.

Materials and methods The potential limitation of hospital drug expenditure has been assessed, using the review of the results of the negotiations reported by several hospitals, prices reported in the National Observatory of Prices and current official price lists published by the Ministry for Health and Social Solidarity.

Results In some cases, up to 80% discount on the initial prices was reported, with the average of around 40%. The emphasis has been put on generic and off-patent products. Medicines categories where the biggest discounts have been observed include: antibiotics (eg, meropenem, piperacillin/tazobactam), cytotoxic agents (eg, paclitaxel, cisplatin, carboplatin, gemcitabine), ondansetron, propofol, omeprazole, etc. Larger hospitals seem to be more powerful in the negotiating procedure. However the bed capacity may not reflect the actual consumption, since the type of hospital bed and the distribution per medical specialty should be taken into account as well.

Conclusions It is possible for hospital pharmacists to gain resources by cutting the cost of medicines in hospital care, while ensuring patient safety. The first results reported seem quite positive given the burden of the unfortunate economic conditions; however other considerations should be borne in mind when coordinating such a procedure, for example transparency, patient safety, availability of pharmacoeconomic and bioequivalence studies and all that in respect to the global market rules.

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