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Title: Greek Crisis Has Pharmacists Pleading for Aspirin as Drug Supply Dries Up
Source:
Bloomberg
URL Source: http://www.bloomberg.com/news/2012- ... n-as-drug-supply-dries-up.html
Published: Jan 12, 2012
Author: Naomi Kresge
Post Date: 2012-01-12 07:04:07 by CZ82
Keywords: None
Views: 15570
Comments: 40
Greek Crisis Has Pharmacists Pleading for Aspirin as Drug Supply Dries Up By Naomi Kresge - Jan 10, 2012 5:01 PM ET . The 12,000 pharmacies that dot almost every street corner in Greek cities are the damaged capillaries of a complex system for getting treatment to patients. Photographer: Louisa Gouliamaki/AFP/Getty Images . For patients and pharmacists in financially stricken Greece, even finding aspirin has turned into a headache. Mina Mavrou, who runs a pharmacy in a middle-class Athens suburb, spends hours each day pleading with drugmakers, wholesalers and colleagues to hunt down medicines for clients. Life-saving drugs such as Sanofi (SAN)’s blood-thinner Clexane and GlaxoSmithKline Plc (GSK)’s asthma inhaler Flixotide often appear as lines of crimson data on pharmacists’ computer screens, meaning the products aren’t in stock or that pharmacists can’t order as many units as they need. “When we see red, we want to cry,” Mavrou said. “The situation is worsening day by day.” The 12,000 pharmacies that dot almost every street corner in Greek cities are the damaged capillaries of a complex system for getting treatment to patients. The Panhellenic Association of Pharmacists reports shortages of almost half the country’s 500 most-used medicines. Even when drugs are available, pharmacists often must foot the bill up front, or patients simply do without. The financial crisis is brewing a “Greek tragedy” of slowing access to medical care and worsening outcomes for patients, Martin McKee, a professor of European public health at the London School of Hygiene and Tropical Medicine, wrote in an October article in The Lancet. The Greek Ministry of Health didn’t respond to repeated requests for comment. ‘Many Difficulties’ “It would be unrealistic to deny that there are many difficulties regarding all public services due to the financial crisis,” Nicolaos Polyzos, secretary general of the Ministry of Health, wrote in a response to McKee’s article posted on the ministry’s website. “However, this cannot justify characterizing the current picture of (the) health sector in Greece as a ‘tragedy.’” The reasons for the shortages are complex. One major cause is the Greek government, which sets prices for medicines. As part of an effort to cut its own costs, Greece has mandated lower drug prices in the past year. That has fed a secondary market, drug manufacturers contend, as wholesalers sell their shipments outside the country at higher prices than they can get within Greece. Strained government finances only make matters worse. Wholesalers and pharmacists say the system suffers from a lack of liquidity, as public insurers delay payments to pharmacies, which in turn can’t pay suppliers on time. “Wholesalers simply do not have the money anymore to play bank to the pharmacies,” Heinz Kobelt, secretary general of the European Association of Euro-Pharmaceutical Companies, said in a telephone interview. 330 Million Euros Public insurers owe pharmacists some 330 million euros ($422.1 million) for drugs bought since April, Dimitris Karageorgiou, vice-chairman of the pharmacists’ association, said in an interview last month. Payment can take three months to up to a year, pharmacists said. Some are turning to patients to pay up front. “They’re saying you pay me now, and then you’ll get the money from your social security fund,” said Ioannis Theodorakis, chairman of the Association of Persons with Multiple Sclerosis. Theodorakis said he already knows a few patients who can’t afford to pay and aren’t on treatment. If non-payment by public insurers continues, more will discontinue treatment, he said in an interview in his office in Athens, a few steps from where protesters lob Molotov cocktails and pelt police with rocks at Syntagma Square. ‘Dysfunctional’ System “The whole system is dysfunctional,” said Aggeliki Matsouki, who opened her first pharmacy in Athens in 1981. Chain-smoking in her tiny back office, Matsouki described calling other pharmacies to track down London-based Glaxo’s oral herpes drug Famvir. “If I can’t find a prescription drug, I try to borrow it from colleagues. We exchange medicines.” Austerity measures imposed to address the financial crisis may paradoxically be making matters worse. Greek wholesalers now have more incentive than ever to sell drugs outside the country after Greece implemented a law last year further reducing prices. The law sets prices of medicines according to the average of the three lowest charges in 22 European Union countries, part of an effort to trim a health bill that in 2010 totaled more than 13 billion euros, or about 5 percent of GDP. Parallel Trading Parallel imports peaked in 2004, then flattened out about two years ago once drugmakers imposed quotas of the maximum amount of medicines they think the Greek market will need, said Kobelt, whose Brussels-based association represents companies engaged in the trade. Still, if pharmacies can’t pay, it makes economic sense to ship the drugs back out again rather than let them languish on wholesalers’ shelves, he said. Kobelt said he’s seen boxes of Bayer AG (BAYN)’s Aspirin in Poland that originated in Greece, suggesting that the medicine fetches higher prices in eastern Europe. “Even Polish people pay more than Greeks for Aspirin,” he said. “That is the recipe for parallel trade, I’m sorry to say.” Novo Nordisk A/S (NOVOB), based in Bagsvaerd, Denmark, is a case in point. “We are competing with our own products,” said Mike Rulis, a spokesman for the company. Novo stopped selling some of its higher-priced insulins in Greece for about a month in 2010 after the government cut prices by about 25 percent. The drugmaker now ships in the same volume as before the cuts, yet pharmacists are running short of insulin, Rulis said in a telephone interview. Special Deliveries “There are cases where pharmacies will call our Greek affiliate and say, ‘We are out of stock, can you help us,’” he said. “Then we will call the wholesaler to make a special delivery.” Reimbursement fraud compounds the drain on the country’s health resources, Richard Bergstrom, director-general of European Federation of Pharmaceutical Industries and Associations, said in an interview. Drugs shipped elsewhere yet submitted for reimbursement to public insurers as if they had been prescribed to patients cost Greece more than 500 million euros a year, Bergstrom said, citing figures he said he got from the Ministry of Health. In a later e-mail, Bergstrom said he had personally seen packs of drugs with Greek reimbursement stickers on the market outside of Greece, suggesting that exporters were reimbursed and able to ship the packs abroad. “If the pack is exported, the exporter is obliged to ’cancel’ the code, a bar code, by using a black pen,” Bergstrom wrote. “But this is not monitored.” Up-Front Payment Not all pharmacists can afford to pay up-front for costly drugs in the hope of being reimbursed by insurers. An invoice provided to Bloomberg News shows Roche Holding AG (ROG) requesting a 926-euro payment in advance from a pharmacy for NeoRecormon, a medicine used to treat anemia in chemotherapy and chronic kidney disease patients. The Swiss drugmaker switched to a payment-on-delivery policy for hospitals with a history of nonpayment last year after accepting 400 million Swiss francs ($426.7 million) in Greek government bonds for unpaid hospital debts. The Greek government announced in December 2010 it would issue more than 5 billion euros of non-interest paying bonds to hospital suppliers for unpaid bills from 2007 to 2009. Roche extends a credit to pharmacies and in some cases has extended credit limits to ensure patients can get drugs, Daniel Grotzky, a company spokesman, said in a telephone interview. “This might be a pharmacy which has used up its credit line,” he said. Difficult Decisions A year ago, the Health Ministry advised MS patients to buy medicine through state hospitals, Theodorakis said. Those hospitals often don’t have enough drugs, so patients go to pharmacies instead, he said. Theodorakis stopped taking Merck KGaA (MRK)’s Rebif in 2006 because he wasn’t satisfied the drug’s benefits outweighed its side effects in his particular case. The frustrating process of obtaining medicine contributed to his decision not to start taking another drug, said Theodorakis, who uses a wheelchair and has an assistant to type his e-mails. “It’s a difficult decision to make because you can’t play dice with your health,” Theodorakis said.
Poster Comment: But I thought the State sponsored single payer Healthcare systems were supposed to keep things like this from happening!!!! (sarcasm)...... And ObozoCare is supposed to fix all of our problems..... "NOT"!!!!!!
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#1. To: CZ82 (#0)
ObamaCare, Medicaid, & Medicare already set the price of medicine, medical treatments, & provider payments. I know of a MS Medicaid patient that was denied a medicine just last week which had worked for her when the cheaper ones had already been tried and failed. Physicians in the Government Healthcare-VA hospitals are complaining that it takes 6 months to get an MRI approved, one doctor I know there says the delay has cost at least one of her patients his life. The most deadly cancer known to man is Big Government.
BULLSHIT.
I'll believe that a corporation is a person 1 second after Texas executes one...
Bullshit my ass, true story. The patient had been taking a name brand with good results for 2 years, after first trying the cheap stuff with no results, but Medicaid said no more. Then the physician sent a letter, which took an uncompensated hour of work to write, explaining why the patient needed this particular med. The government then faxed an 8 page form for appeal, another 1 1/2 hours of uncompensated paperwork, requesting the same information they had already received in the letter, which had to filled returned within 24 hours. The physician didn't even see it until the late next evening when she normally checks & responds correspondence. Not only that, they faxed something to the patient to fill out too, like they expect Medicaid patients all have fax machines sitting around & operational in their Section 8 housing. Bottom line, patient gets no meds that work, doctors lose more money wasting hours of time on unnecessary paperwork for Medicaid patients that they already lose money on treating, even w/o the added bureaucrat generated obstacles. And worthless parasitic bureaucrats waste billions getting paid to generate paperwork denying patients the care they need.
Medicare policy on meds changed with the prescription drug program. Patients afflicted with long term illnesses with no chance of getting better are no longer denied medication based upon the fact of their condition being one which will not improve. Medicare will still deny some physical therapy for that reason but my experience with Medicare with Parkinson's, which is in the same Medicare catagory as MS, is that any medication that was within the accepted Parkinson's protocol was covered. Your friend if s/he was, in fact, denied, should appeal. Someone screwed up.
I'll believe that a corporation is a person 1 second after Texas executes one...
I call BS again. The appeal form is, in fact, one page.
I'll believe that a corporation is a person 1 second after Texas executes one...
It's probably the state cutting back on social services due to diminishing tax revenues and the need to balance its budget. No doubt everything will be better when the god of the free market reigns supreme - long live Ron Paul.
Economics is a social phenomenon and in no way a “science”, no matter how desperately its high priests would like to have it believed otherwise. It is, instead, a branch of anthropology and the sooner that is recognized and accepted, the better off human-kind in general and the world of academic economics, in particular, shall be proximity1 We probably will see widespread civil disorder in the 1980s, as a direct result of our faltering economic system. Ron Paul
I'm telling you she did, and the government faxed back paperwork with an impossible to meet deadline to the doctor and the patient's non-existant fax machine. Not only that, they've wasted 6 hours of the doctor's time so far that could have been spent seeing other patients. Now the patient who wasn't having to see the doctor very often will be making frequent visits in search of another medication that's OK with Washington, DC. And again, Medicaid, & Medicare do not even reimburse enough to cover the expenses of the most routine of visits, and a large majority of those expenses are the result of government regulations. The rest are the result of CYA from the trial lawyers (who just happen to all be Democrats & Big Money Democrat contributors, BTW). Government is what's wrong will healthcare, and every new thing they do to diddle w/ it makes it worse. Everything government's ever fucked with, government's fucked up. Everything. Why anyone would think ObamaCare would be different is beyond me.
My next door neighbor, 50, died this morning. Cancer.
You for Paul now? I thought you were an Obama supporter, when did that change?
How is 120 days an impossible deadline? Your "story" has more holes than a New Orleans cathouse...
I'll believe that a corporation is a person 1 second after Texas executes one...
Maybe in your state, not here. Then again, maybe the form is one page & the other 7 are yadda-yadda-yadda. I'll ask my sources next time I get a chance.
24 hours, the doctor was required to fax the paperwork back in 24 hours. Paperwork she didn't even see until around 24 hours later.
I'm sorry. A dear, sweet friend died yesterday morning from Alzheimer's.
Economics is a social phenomenon and in no way a “science”, no matter how desperately its high priests would like to have it believed otherwise. It is, instead, a branch of anthropology and the sooner that is recognized and accepted, the better off human-kind in general and the world of academic economics, in particular, shall be proximity1 We probably will see widespread civil disorder in the 1980s, as a direct result of our faltering economic system. Ron Paul
No.
Economics is a social phenomenon and in no way a “science”, no matter how desperately its high priests would like to have it believed otherwise. It is, instead, a branch of anthropology and the sooner that is recognized and accepted, the better off human-kind in general and the world of academic economics, in particular, shall be proximity1 We probably will see widespread civil disorder in the 1980s, as a direct result of our faltering economic system. Ron Paul
Medicare doesn't have the equivalent of 50 states worth of different forms. The forms I used in PA were the same ones that I used in MI. But, you could be correct that it might have been a local issue. Between my mother and my step-mother, there were very few aspects of Medicare that I haven't dealt with at some point - including Part D which actually made more medications available for my mom's Parkinson's.. Never had a problem dealing with them. Ever. Didn't like what they did or determined on occasion but I was never treated coldly or indifferently or given "impossible deadlines" or 8 pages to fill out.
I'll believe that a corporation is a person 1 second after Texas executes one...
Medicare gives 120 days for all appeals. Something is whacked somewhere.
I'll believe that a corporation is a person 1 second after Texas executes one...
Bummer dudes...
I'll believe that a corporation is a person 1 second after Texas executes one...
You scrape the inner lining from the bark of willow trees and add vinegar. What precipitates out is aspirin The Greeks discovered the process.
"ROTFLMAO... Perfect! She longs... for someone to Teabag her. a man that squats on top of a women's face and lowers his genitals into her mouth during sex, known as "teabagging" She aches for it"... ~~~JWpegler. Head Tea Bagger and Tea Party supporter extraordinaire, explicitly expressing his fantasies in public about other posters.
Where do I find my closest free market in order to properly display my gratitude?
"ROTFLMAO... Perfect! She longs... for someone to Teabag her. a man that squats on top of a women's face and lowers his genitals into her mouth during sex, known as "teabagging" She aches for it"... ~~~JWpegler. Head Tea Bagger and Tea Party supporter extraordinaire, explicitly expressing his fantasies in public about other posters.
Something is whacked somewhere. This is Medicaid. There may be another level of appeal though, there probably is. But even if in the end the patient gets the proper medication again the dosage has to be recalibrated when she gets back on it, and countless hours of the doctor's time have been wasted with unnecessary paperwork and patient visits that wouldn't have been required if the bureaucrats had left well enough alone. But we all know why the government really does this shit, it's an excuse to keep parasitic paper shufflers paid in DC and the state offices. They don't give a rat's ass about the patients or the people actually doing the real work of treating them.
Yep. That's what happens when you want to make sure no undeserving person gets something for nothing. BTW, health insurance works the same way.
Economics is a social phenomenon and in no way a “science”, no matter how desperately its high priests would like to have it believed otherwise. It is, instead, a branch of anthropology and the sooner that is recognized and accepted, the better off human-kind in general and the world of academic economics, in particular, shall be proximity1 We probably will see widespread civil disorder in the 1980s, as a direct result of our faltering economic system. Ron Paul
No. Are you actually saying you prefer Obama to Paul?
Loony will support whoever promises her a "free" lunch. If it comes down to a choice between Mitt and oBUMa, she'll vote for whoever promises the bigger free lunch.
"If ye love wealth better than liberty, the tranquility of servitude than the animated contest of freedom, go from us in peace. We ask not your counsels or arms. Crouch down and lick the hands which feed you. May your chains sit lightly upon you, and may posterity forget that you were our countrymen!” -- Samuel Adams --
Just what I said, undeserving overpaid bottom feeding bureaucrat parasites screwing stuff up.
That is just the point, there is no free lunch. It is illogical to blame government for not providing what conservatives refuse to pay for.
Economics is a social phenomenon and in no way a “science”, no matter how desperately its high priests would like to have it believed otherwise. It is, instead, a branch of anthropology and the sooner that is recognized and accepted, the better off human-kind in general and the world of academic economics, in particular, shall be proximity1 We probably will see widespread civil disorder in the 1980s, as a direct result of our faltering economic system. Ron Paul
Like health insurance provider CEOs?
Economics is a social phenomenon and in no way a “science”, no matter how desperately its high priests would like to have it believed otherwise. It is, instead, a branch of anthropology and the sooner that is recognized and accepted, the better off human-kind in general and the world of academic economics, in particular, shall be proximity1 We probably will see widespread civil disorder in the 1980s, as a direct result of our faltering economic system. Ron Paul
If it comes down to a choice between Mitt and oBUMa, she'll vote for whoever promises the bigger free lunch. And you will vote for whomever promises that they will fulfill your corporation run, free market utopia, figment of your imagination.
"ROTFLMAO... Perfect! She longs... for someone to Teabag her. a man that squats on top of a women's face and lowers his genitals into her mouth during sex, known as "teabagging" She aches for it"... ~~~JWpegler. Head Tea Bagger and Tea Party supporter extraordinaire, explicitly expressing his fantasies in public about other posters.
Only a liberal Republican't like you would make up a nonsense sentence like that. It only bothers you to be called such a creature because you actually are one.
Yep.
Economics is a social phenomenon and in no way a “science”, no matter how desperately its high priests would like to have it believed otherwise. It is, instead, a branch of anthropology and the sooner that is recognized and accepted, the better off human-kind in general and the world of academic economics, in particular, shall be proximity1 We probably will see widespread civil disorder in the 1980s, as a direct result of our faltering economic system. Ron Paul
Heh, I love invoking the high on a Richter scale thing that is a lightning fast response from you is in showing how much being a liberal Republican't bothers you when others point out that this is you are. It would not stink, without some relevant sting to it. And oh yes sweet boy, Ms. Warren will indeed be a fine junior Senator from Mass when she kicks Dumbo's ass next November. ;-D
I really don't care, Scotty's just a Northeast RINO progtard. No great loss.
If it comes down to a choice between Mitt and oBUMa, she'll vote for whoever promises the bigger free lunch. Just in case you missed it - there is no free lunch. People like you make sure they get their fill feeding at the trough while resenting every penny the infrastructure that supplies the trough costs.
Economics is a social phenomenon and in no way a “science”, no matter how desperately its high priests would like to have it believed otherwise. It is, instead, a branch of anthropology and the sooner that is recognized and accepted, the better off human-kind in general and the world of academic economics, in particular, shall be proximity1 We probably will see widespread civil disorder in the 1980s, as a direct result of our faltering economic system. Ron Paul
When I was in the Air Force I spent 6 weeks in Greece. The American Airbase in Greece is at the Athens Airport. About 50 Greeks worked on base as cooks and janitors. Everyday, the Greeks who worked on the base gathered to hand me money to go buy them soap and shampoo at the U.S. Air Force Commissary. Don't they have their own soap and shampoo? No, they don't. And heavy Greek tariffs make is extraordinarily expensive for Greeks to buy imported soap and shampoo at the store. This is was 1981. Greece has been screwed up with big government for a long time. We don't need their kind of nonsense in America. By the way, my first wife was Greek. So, I totally get it.
Well there are a few on LF that are "beyond you" because they think just that.. Guess they would rather trade their freedom for some chinsy ass freebies... I can't wait to hear their whining asses when they finally figure out they phucked up when they sold their souls to the devil/government!!!!! And you know what they'll say...... "I only wanted free HealthCare"!!!! (Well guess what idiot it ain't free and it aint worth a schitt)....
Quiz of the Day: Who made the statement "The world would be a better place if only Men were to vote?????? HINT: It was a woman!!!
The American Airbase in Greece is at the Athens Airport. I had a couple of layovers at Hellenikon but never had enough time between flights to go see much of anything.... Wish I could have spent a few months there to go see some of the sights..... Too bad that it's closed down now... My wife used to get so mad when I would come home with a bunch of pictures from the countries I had been TDY to.... She would say "Why the hell can't I go along"!!!!!!
Quiz of the Day: Who made the statement "The world would be a better place if only Men were to vote?????? HINT: It was a woman!!!
Was she a mail-order bride?
She was born in America. I met her in college. The Greek culture is such that Greeks consider themselves Greeks before anything else. Her entire family thought that she was getting into a "mixed marriage", because I am not Greek. Have you ever seen "My Big Fat Greek Wedding"? That's pretty much how it is. The only thing that I found completely unrealistic about that movie is that the Orthodox Priest didn't have a bread. Orthodox Priests always have beards.
No I haven't seen it but I've heard it was a popular motion picture. I'll try to watch it sometime.
Unless they lose their balls to a bizarre rice grinder accident as a chid and refuse to undergo hormone replacement therapy of course. ;-D
One major cause is the Greek government, which sets prices for medicines.
#2. To: Happy Quanzaa (#1)
I know of a MS Medicaid patient that was denied a medicine just last week which had worked for her when the cheaper ones had already been tried and failed.
#3. To: war (#2)
#4. To: Happy Quanzaa (#3)
#5. To: Happy Quanzaa (#3)
The government then faxed an 8 page form for appeal
#6. To: Happy Quanzaa (#3)
Bottom line, patient gets no meds that work, doctors lose more money wasting hours of time on unnecessary paperwork for Medicaid patients that they already lose money on treating, even w/o the added bureaucrat generated obstacles. And worthless parasitic bureaucrats waste billions getting paid to generate paperwork denying patients the care they need.
#7. To: war (#4)
(Edited)
in fact, denied, should appeal.
#8. To: lucysmom (#6)
#9. To: lucysmom (#6)
long live Ron Paul
#10. To: Happy Quanzaa (#7)
I'm telling you she did, and the government faxed back paperwork with an impossible to meet deadline to the doctor and the patient's non-existant fax machine.
#11. To: war (#5)
The appeal form is, in fact, one page.
#12. To: war (#10)
How is 120 days an impossible deadline?
#13. To: Fred Mertz (#8)
My next door neighbor, 50, died this morning. Cancer.
#14. To: Happy Quanzaa (#9)
You for Paul now?
#15. To: Happy Quanzaa (#11)
Maybe in your state, not here.
#16. To: Happy Quanzaa (#12)
#17. To: lucysmom, Fred Mertz (#13)
#18. To: CZ82 (#0)
(Edited)
#19. To: lucysmom (#6)
It's probably the state cutting back on social services due to diminishing tax revenues and the need to balance its budget. No doubt everything will be better when the god of the free market reigns supreme - long live Ron Paul.
#20. To: war (#16)
(Edited)
Medicare gives 120 days for all appeals.
#21. To: Happy Quanzaa (#20)
But even if in the end the patient gets the proper medication again the dosage has to be recalibrated when she gets back on it, and countless hours of the doctor's time have been wasted with unnecessary paperwork and patient visits that wouldn't have been required if the bureaucrats had left well enough alone.
#22. To: lucysmom (#14)
You for Paul now?
#23. To: A K A Stone (#22)
Question: You for Paul now?
lucysmom: No.
AKA Stone: Are you actually saying you prefer Obama to Paul?
#24. To: lucysmom (#21)
Yep. That's what happens when you want to make sure no undeserving person gets something for nothing.
#25. To: Capitalist Eric (#23)
Loony will support whoever promises her a "free" lunch.
#26. To: Happy Quanzaa (#24)
Just what I said, undeserving overpaid bottom feeding bureaucrat parasites screwing stuff up.
#27. To: Capitalist Eric (#23)
(Edited)
Loony will support whoever promises her a "free" lunch.
#28. To: Happy Quanzaa (#20)
"There may be another level of appeal though, there probably is."
#29. To: Ferret Mike (#28)
#30. To: A K A Stone (#22)
#31. To: Happy Quanzaa (#29)
#32. To: Ferret Mike (#31)
she kicks Dumbo's ass
#33. To: Capitalist Eric (#23)
(Edited)
Loony will support whoever promises her a "free" lunch.
#34. To: CZ82 (#0)
(Edited)
Iran’s main drive for acquiring atomic weapons is not for use against Israel but as a deterrent against U.S. intervention -- Major General Zeevi Farkash, head of the Israeli Military Intelligence Directorate
#35. To: Happy Quanzaa (#7)
Everything government's ever fucked with, government's fucked up. Everything. Why anyone would think ObamaCare would be different is beyond me.
#36. To: jwpegler (#34)
When I was in the Air Force I spent 6 weeks in Greece.
#37. To: jwpegler (#34)
By the way, my first wife was Greek. So, I totally get it.
#38. To: Fred Mertz (#37)
Was she a mail-order bride?
Iran’s main drive for acquiring atomic weapons is not for use against Israel but as a deterrent against U.S. intervention -- Major General Zeevi Farkash, head of the Israeli Military Intelligence Directorate
#39. To: jwpegler (#38)
Have you ever seen "My Big Fat Greek Wedding"?
#40. To: jwpegler (#38)
"Orthodox Priests always have beards."
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