Mandatory generic prescribing is expected to save Spain €2bn a year

BMJ 2011; 343 doi: http://dx.doi.org/10.1136/bmj.d4803 (Published 27 July 2011)
Cite this as: BMJ 2011;343:d4803

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Dear Editors, Even if mandatory generic prescribing is finally implemented in Greece, no money will be saved. All pharmaceuticals in Greece, prototypes or generics alike, came to cost exactly the same! [1] How can different Pharmaceutical Companies, from different European Countries, producing different pharmaceutical products, in different factories, sell at exactly the same price? Is there any competition in a free market or what? Reference [1] http://www.eopyy.gov.gr/%CE%88%CE%B3%CE%B3%CF%81%CE%B1%CF%86%CE%B1%20%CE...

Competing interests: Dr Stavros Saripanidis is a diligent taxpayer who is called to pay for ever increasing pharmaceutical expenditures in Greece.

Stavros Saripanidis, Consultant in Obstetrics and Gynaecology

Private Surgery, Thessaloniki, Greece

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Dear Editors,

Compulsory prescription by active substance was supposed to be established in the first months of year 2012, according to this signed Greece-IMF memorandum. [1]

“Mandating the substitution of prescribed medicines by the lowest–priced product of the same active substance in the reference category by pharmacies”(compulsory "generic substitution"). [Q1-2012]

There is absolutely no cost in implementing this measure.

Indeed it is going to save billions!

Yet, for months, politicians in my Country have been deliberately stalling implementation.

IMF money has saved my Country from economic destruction.

Why should politicians risk breaking this pact by non implementing signed conditions?

Reference

[1] http://www.imf.org/external/np/loi/2012/grc/030912.pdf

Competing interests: Dr Stavros Saripanidis wants to prescribe cheap generics by active substance but the Greek Government won’t let him!

Stavros Saripanidis, Consultant in Obstetrics and Gynaecology

Private Surgery, Thessaloniki, Greece

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Dear Editors,

New evidence reveals that, every year, 1 billion euros worth of pharmaceuticals are thrown away from households alone, in Greece. [1][2]

This figure does not include public hospital pharmaceuticals!

Furthermore, only a small percentage of these are generics.

It is evident that over-prescription of pharmaceuticals in Greece is still widespread, despite tough austerity measures and constant IMF-EU-ECB surveillance.

References

[1] http://www.ekathimerini.com/4dcgi/_w_articles_wsite1_1_08/02/2012_426697

[2] http://www.athensnews.gr/portal/1/53081

Competing interests: Dr Stavros Saripanidis is a diligent Greek taxpayer who pays for all these expensive pharmaceuticals that get thrown away.

Stavros Saripanidis, Consultant in Obstetrics and Gynaecology

Private Surgery, Thessaloniki, Greece

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Dear Editor,

A single transparent online international auction permitted Greek hospitals to achive an amazing 92% cost reduction on antibiotics! [1]

Greek taxpayers have been paying for decades very expensive pharmaceutical products.

Evidently, 92% more profit could generate extensive and longlasting corrurtion…

Reference

[1] http://www.greeknewsagenda.gr/2011/11/e-procurement-for-generic-drugs-sa...

Competing interests: Dr Stavros Saripanidis is a diligent Greek taxpayer who has apparently funded more corruption than hospital drugs.

Stavros Saripanidis, Consultant in Obstetrics and Gynaecology

Private Surgery, Thessaloniki, Greece

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Dear Editor,

Mandatory generic prescribing is a very useful, practical and secure way to save money, avoid licensing corruption, end over-prescribing.

2bn euro per year is a lot of money.

In Greece, the amount of money saved could be much more, even if the Country has only a fraction of Spain's population.

This is because in Greece over-prescribing, under the counter deals, inefficient public healthcare management, and worse have existed for decades and have geometrically increased pharmaceutical expenditure. [1] [2] [3] [4] [5] [6] [7] [8] [9]

Greece is by far the first European Country in pharmaceutical expenditure per capita! [10] [11]

Last week the Ministry of Health working together with the Ministry of Social Welfare decided to copy this Spanish law. They changed plans the next day, after some meetings with officials working for Pharmaceutical Companies!

Why?

Electronic prescriptions were planned to monitor excessive expensive preferences......

Tens of millions were spent for various IT consultations, conferences, planning platforms, testing, etc

Why?

Pharmacies had already in use a very efficient system, which was offered to anyone interested, free of charge!

Only a small percentage of Public Hospitals and Surgeries have managed to implement electronic prescribing so far.

Why?

References

[1] BMC Health Serv Res. 2005 May 28;5:41. Organisation and financing of the health care systems of Bulgaria and Greece -- what are the parallels? Exadaktylos NM. Higher Technological Educational Institute of Thessaloniki (A.T.E.I.T.), Vasilis Olgas 6, 54640, Thessaloniki, Greece.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1156891/?tool=pubmed

[2] Health Syst Transit. 2010 Nov;12(7):1-177. Greece health system review. Economou C. Panteion University of Social and Political Sciences. World Health Organization 2010, on behalf of the European Observatory on health systems and Policies.

http://www.ncbi.nlm.nih.gov/pubmed/21330233

[3] Health Econ. 2005 Sep;14(Suppl 1):S151-68. Analysing the Greek health system: a tale of fragmentation and inertia. Mossialos E, Allin S, Davaki K. London School of Economics and Political Science, LSE Health and Social Care, UK.

http://www.ncbi.nlm.nih.gov/pubmed/16161195

[4] Health Policy. 2008 Jul;87(1):72-81. Epub 2008 Feb 4. Informal payments in public hospitals in Greece. Liaropoulos L, Siskou O, Kaitelidou D, Theodorou M, Katostaras T. Center for Health Services Management and Evaluation, Faculty of Nursing, University of Athens, Greece.

http://www.ncbi.nlm.nih.gov/pubmed/18249459

[5] Stavros Saripanidis' Rapid Response in:

http://www.bmj.com/content/342/bmj.d2408.extract/reply#bmj_el_264556

[6] Stavros Saripanidis' Rapid Response in:

http://www.bmj.com/content/343/bmj.d4870.extract/reply#bmj_el_268394

[7] Stavros Saripanidis' Rapid Response in:

http://www.bmj.com/content/339/bmj.b3783.extract/reply#bmj_el_267048

[8] http://www.ihs.com/products/global-insight/industry-economic- report.aspx?ID=1065930281

[9] http://latest-business.com/healthcare-industry/why-patients-in- greek-state-owned-hospitals-cant-obtain-cancer-treatments/

[10] http://www.onmedica.com/newsArticle.aspx?id=098f821c-94bb-4acf- ac08-e663361e74ed

[11] http://www.cmaj.ca/content/183/9/E523.full.pdf

Competing interests: None declared

Stavros Saripanidis, Consultant in Obstetrics and Gynaecology in Greece

Private Sector, 55131

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