Galery

1

Minister of Health Adonis Georgiadis has submitted to the service combating economic crimes a list of doctors who had issued the highest number of prescriptions in June 2013. Georgiadis has asked for an immediate check and if it shows that there has been a violation, the doctors will face the relevant disciplinary authorities. Just a few days ago, Ethnos newspaper published an article about the violations which doctors and pharmaceutical companies had made at the expense of the insured and the health insurance fund. The medical association has subsequently requested that the names of the doctors be submitted to the competent authorities.

The incredible cases of issuing false prescriptions are as follows:

A number of prescriptions issued
• A general practitioner from Macedonia had issued 4,388 prescriptions per month which correspond to 150-200 prescriptions per day
• A general practitioner from Ceres had issued 2,700 prescriptions per month worth 120,000 euro
• A pathologist from Agrinio had issued 2,800 prescriptions per month worth 115,000 euro.
• A general practitioner from Thrace had issued 3,200 prescriptions per month
• A general practitioner from the same centre had issued 3,180 prescriptions during the same month
• A pathologist had issued 33 prescriptions per month with an average prescription value of 3,400 euro and total value of 110,000 euro.

Prescriptions issued in favour of a certain company
• A doctor had issued 93% of the prescriptions in favour of a multinational pharmaceutical company which corresponds to 1% of the total turnover in his specialty.
• A pathologist in Attica had issued about 2,000 prescriptions per month, the value of which was 40% above the average and their total monthly turnover was over 100,000 euro.
• A pathologist in Attica had issued prescriptions in favour of a particular company with a turnover of 85,000 euro.
• A paediatrician from Attica had issued prescriptions in favour of a particular firm which correspond to 70 % of the medicines prescribed by him.

Dispensing prescriptions by specific pharmacies
• 84% of the prescriptions issued by a pathologist from Attica were dispensed by a specific pharmacy. The value of the prescriptions issued by the particular doctor constitutes 95 % of the pharmacy’s turnover.
• 70% of the prescriptions issued by a general practitioner from Agrinio were dispensed by a specific pharmacy. The value of the prescriptions issued by the particular doctor constitutes 90% of the pharmacy’s turnover.
• The prescriptions issued by a doctor from Attica constitute 89% or 50,000 euro of the turnover of a particular pharmacy in which a relative of his is working.
• The prescriptions issued by a doctor from Attica constitute 95% of the turnover of a specific pharmacy.
• The prescriptions issued by a doctor from Ceres constitute 85% of the turnover of a particular pharmacy in which a relative of his is working.
• The prescriptions issued by a doctor from Ioannina constitute 83% of the turnover of a specific pharmacy which is employing a relative of his.

Suspicious insured
• An insured person had received within 1 month 15 prescriptions for a total of 785 packages of medicines worth 8,500 euro.
• An insured person had received within 1 month 9 prescriptions for a total of 400 packages of medicines.

The main tool to control the costs of medicines is generics. They are copies of the original medicines, have the same quality as the original medicines but are less expensive. The rate of use of generics in Greece is low in comparison with other European countries. It is between 16 % and 19 % whereas it is higher than 60% in the Netherlands and Germany, for example. The aim of the Ministry of Health is for the percentage in Greece to reach this value. Nevertheless, could these measures reduce the cost of medicines?

The life cycle of an original medicine has 3 stages. The first involves research and development of the new medicine until its launching on the market. The second includes its launching on the market until the expiration of the exclusive distribution right. In Europe, the patent is protected for 20 years. In the third stage, the medicine loses its patent. At this point, the market can freely distribute medicines the composition of which is identical to that of the original medicine and which have the same effect. Their prices are much lower and can reach 10-20 % of the price of the original medicine. The price of the original itself drops when its patent expires and the decrease in Greece is 50%.

How could the prescriptions that prescribe an active substance instead of a specific medicine help the costs of medicines? Each package has a double "passport". The first is the trade name (aspirin) and the second is the active substance (acetyl salicylic acid). If the doctor writes "aspirin" in the prescription, the pharmacist is obliged to give the specific medicine. But if the doctor writes "acetyl salicylic acid", then the pharmacist can give the patient any generic containing the specific substance (salospir, algon, calmol). This automatically decreases the value of the prescription. Very often, however, when the patent of a medicine expires, the doctors begin to prescribe other medicines the patent of which is still in force and which are more expensive and have the same therapeutic qualities. This increases the cost of medicines. Therefore, different countries have taken measures for mandatory prescription of generics.