GREECE
From the survey • The very low number of respondents with diabetes other than type 1 diabetes makes it difficult to discuss access for all people with diabetes • Based on collected responses and discussions with the Hellenic Diabetes Federation, it appears that the main barrier to access to medicines and medical devices has been due to the impact of the economic crisis on people and the effect of austerity measures on healthcare services. o While stock issues have a limited impact on diabetes products, healthcare professionals and people with diabetes reported affordability issues and increased difficulties to access healthcare. • Although the majority of surveyed people with diabetes reported having received education or information about treatment, this is not universal and was far less frequent among their relatives
Healthcare expenditure profile (2011)2
Key background information: country health system
Public expenditure Private expenditure Out-of-pocket expenditure represents 94.5% of private spending on health
39%
Total health expenditure per capita: USD 2,864.20 Proportion of government expenditure on health: 13.2%
61%
Health system overview
- The Greek population is covered by both the National Health Services and mandatory Health Insurance, administered by multiple health insurance funds.3 - The Ministry of Health and Social Solidarity defines the services offered by the National Health Services3 while the services covered by health insurances have been harmonised over the last years.6 - Most medicines and medical devices are supplied by private actors,5,7 according to the Ministry of Health and Social Solidarity regulations – in line with EU regulations. Different public organisations under the Ministry’s authority ensure that these regulations are applied.3 - A quality issues reporting system is in place.5
Diabetes prevalence1
Key diabetes data
IDF Atlas
National Data
7% of 20-79 year-olds (2011)
Official records: 10% of the population - An additional 20% of the population have impaired glucose tolerance (2008)
Diabetes care procedure
- Prescriptions are provided by diabetes clinicians or GPs depending on who made the initial diagnosis.6 - Prescribers and, in the case of medical devices, manufacturers are the main points of diabetes information and advice.6 - Diabetes products are mostly dispensed at pharmacies. Public hospitals are allowed to dispense diabetes products in some cases.3,5,6
Presence of products at national level
• At least one product from each of the categories surveyed appeared to be authorised for sale and effectively present in the country.5,7
Availability
Guidelines and specific prescription criteria
• Greece has guidelines for diabetes care.1 • The consumption and prescription of diabetes medicines and medical devices is closely related to reimbursement (see Affordability).6 • The choice of diabetes product tends to be left to the judgement of the prescriber.5 o However, the prescription of certain medical devices, such as insulin pumps or additional blood glucose test strips, requires the approval of a medical committee.6
Use
• According to our survey responses, it seems that most of the people treated with insulin are using insulin analogues and insulin pens.5 • The main treatment for people with other types of diabetes could not be assessed.
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