Greek drugmakers warn clawback burden threatens access to innovative medicines

Industry raises access warning

The Hellenic Association of Pharmaceutical Companies, known as SFEE, has warned that Greece’s pharmaceutical financing system has reached a critical point, threatening patients’ access to innovative medicines. In a letter to Prime Minister Kyriakos Mitsotakis ahead of the Thessaloniki International Fair, the association said rising mandatory financial charges are placing growing pressure on drugmakers and the wider health system.

According to To Vima, SFEE argues that the gap between state pharmaceutical funding and patients’ actual needs continues to widen. The shortfall is increasingly transferred to pharmaceutical companies through clawbacks, under which suppliers must return expenditure exceeding public budgets. The association says repeatedly redistributing a rising clawback does not control demand or total spending and instead places a disproportionate burden on innovative treatments.

Hospital drug clawback exceeds 80%

SFEE said pharmaceutical expenditure for uninsured patients has reached €350 million despite a sustained decline in unemployment. Spending through the Institute of Pharmaceutical Research and Technology, or IFET, for emergency medicine imports has climbed to €550 million. The association said this expenditure has effectively made IFET the largest “pharmaceutical company” in Greece.

The pressure is particularly acute in hospital medicines, where SFEE says both supply and demand are controlled by the state. Pharmaceutical expenditure in this segment has risen substantially, while the clawback on medicines priced above €30 exceeds 80%. The association warned that deductions on this scale make the continued supply of affected products to the Greek market extremely difficult. It also said Greece imposes Europe’s highest mandatory returns even though initial medicine prices are relatively low.

Companies seek funding and predictable rules

SFEE also criticised retroactive clawbacks, including charges on medicines that had not sought state reimbursement. It cited medicines supplied through the “PROLAMVANO” obesity programme as an example. The association said some policy decisions are introduced without prior consultation or sufficient predictability, complicating investment and product-planning decisions for pharmaceutical companies.

The industry group is asking the government to strengthen public pharmaceutical funding, potentially using part of the fiscal surplus. It also called for tighter expenditure management through digital tools, treatment protocols and patient registries. SFEE wants a stable and competitive incentive framework for clinical research, arguing that the current environment discourages pharmaceutical innovation and related investment.

New launches and existing supply at risk

If current policies continue, SFEE warned that new innovative medicines could enter Greece late or fail to enter the market at all. It also linked the financial burden to a risk of gradual disinvestment and mounting pressure on treatments already available in the country, noting signs that medicines are being withdrawn from the Greek market.

The association called for a national pharmaceutical strategy based on adequate public financing, effective expenditure controls, regulatory predictability and investment incentives. Its letter, also addressed to the ministers responsible for the economy and finance, health and development, framed the issue as a choice between sustainable financing for pharmaceutical innovation and an eventual reduction in patients’ access to both new and existing treatments.