Patient access to new treatments, the sustainability of pharmaceutical spending, and the future of the clawback mechanism were at the center of the discussion between the Minister of Health, Adonis Georgiadis and the President of the Hellenic Association of Pharmaceutical Companies (SFEE), Olympios Papadimitriou, during the 3rd SFEE Summit organized by the Hellenic Association of Pharmaceutical Companies (SFEE).
The dialogue highlighted both the points of convergence and the differing approaches of the government and the pharmaceutical industry regarding how the growing demand for innovative therapies can be financed without jeopardizing the fiscal stability of the healthcare system.
The Minister of Health argued that the clawback is essentially an expression of the fiscal limits the state imposes on pharmaceutical spending, noting that the real challenge stems from the rapid increase in the use of innovative and more expensive therapies. As a telling example, he noted that for expensive anticancer drugs, hospital spending rose by 21% from 2024 to 2025 and by another 20% in the first quarter of 2026, recording a total increase of 40% over two years.
As he emphasized, “the pharmaceutical industry globally is entering a new era, as more and more innovative therapies are coming to market at significantly higher costs,” putting pressure on the budgets of all countries. “The perpetual increase in spending is not reasonable for a state,” he noted, emphasizing that “the government must ensure the sustainability of the system for all patients.”
Mr. Georgiadis argued that the government has implemented a series of measures to curb overconsumption and better control spending, including strengthening oversight mechanisms, implementing closed budgets, and expanding electronic prescribing.
As announced, electronic prescribing will go live in hospitals on July 1, allowing for real-time monitoring of prescribing behavior, while artificial intelligence tools will subsequently be utilized to monitor prescribing standards.
At the same time, he noted that a significant portion of the new resources allocated in recent years has been directed toward innovative therapies, demonstrating—as he put it—the government’s commitment to supporting innovation. “I now approve 4–5 new drugs per month. The world has changed,” he said.
Defending the overall rationale, the Minister argued that expensive innovative therapies concern a minority of patients—about 25%—while the remaining 75% need established, cheaper drugs that must also be guaranteed, and that the functioning of the rest of the market cannot be disrupted to cover a limited number of rare indications.
He also emphasized that the State “has a responsibility to ensure, first and foremost, access to essential treatments for all patients.” As he said, “innovation is essential and saves lives, but the state must also ensure that the medicines needed by most patients are available.” He added that, thanks to the current policy, “Greece currently has one of the lowest rates of drug shortages in Europe.”
For his part, Mr. Papadimitriou called for a “framework of shared responsibility” from the state, arguing that the government sets the budget without adequately specifying what it is purchasing, with the result that the burden is shifted to the industry.
He revealed that “the day before yesterday we received hospital reports regarding the clawback for the first half of 2025, with average reimbursements at 80.6%,” comparing this treatment to the logic of “it’s as if you’re telling us, ‘you’re stealing from us, and because you’re stealing from us, give back 80%.’” He warned, however, that as long as a joint liability clause is not enacted, “everything the Ministry wants to do is just wishful thinking.”
Citing surveys of the Association’s members, the President of the SFEE spoke of a delay—and a possible reduction—in the entry of new drugs, noting that “companies have no intention of bringing 3 out of 5 innovative drugs to Greece,” looking ahead to the next two to three years.
“Everything is judged by the results,” he added, while expressing concern about Greece’s declining position in the international plans of certain multinational companies.
The Minister challenged the narrative of “stagnation,” arguing that Greece is above the European average in terms of public pharmaceutical funding relative to GDP and that the country continues to attract investments and clinical trials.
“You can’t expect miracles from me,” said Mr. Georgiadis, adding that the increase in spending on innovative medicines creates real pressures that no government can address solely through additional funding. As he said, the goal is to find a middle ground between supporting innovation, market sustainability, and meeting the needs of all patients.
On the pricing front, the SFEE President proposed lifting certain pricing protections and exempting generics from the clawback, while acknowledging that removing the -7% protection would create a supply issue in the retail sector. The Minister countered that the -7% benefit is not distributed evenly across drug categories and proposed that, in a subsequent consultation later this year, an assessment be made of how many on-patent and how many off-patent/generic drugs are affected by the mechanism.