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Healthcare Resource Guide: Greece

 

Greece

Statistics

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Summary
Market Entry

Current Market Trends

Best Prospects

Main Competitors

Current Demand
Barriers

Registration Process

Trade Events

CS Contact

Capital: Athens

Population: 11.1 million (est. 2015)

GDP: €176 billion (2015)

Currency: Euro (€)

Language: Greek (official)

Summary

The Greek healthcare market, inclusive of medical devices, diagnostics, supplies and pharmaceuticals, is extensively dependent on imports, with local production mostly active in generics and the so called “branded generics. Making Greece a gateway to SE Europe could offer the country economy of scale advantages. However, the financial crisis, combined with uneasiness brought by the current refugee situation, has resulted in instability.

Priorities in the sector include:

  • Upgrade in public hospital staffing via the recruitment of 4,500 qualified staff of doctors, nurses, and paramedics to cover gaps that exist across the country.
  • The immediate operation of inoperative “mothballed” Intensive Care Units.
  • The free access of all citizens and refugees to health services and health care, whether insured or not.
  • The immediate full implementation of national electronic health records, which is an EU member-state obligation.
  • The support and growth of health centers and hospitals on certain small and distant island and mountain regions, such as the Aegean Islands, Thrace, Western Macedonia and Epirus.

The government is finalizing the merger of certain hospital units and attempting a twenty-four hour operation standard within all public hospitals, with a greater level of transparency in hospital financial transactions and hospital procurement. Healthcare expenditures currently amount to 5.4% of Greece’s diminishing Gross Domestic Product (GDP). This expenditure has traditionally comprised of approximately 60% government–provided care and 40% private care. Preference for receiving private healthcare has traditionally been higher in Greece because nearly any procedure can be performed and wait times are much lower in private hospitals. In addition, if a procedure requires an overnight stay, the largely crowded and rundown appearance of public hospitals is something people wish to avoid when they have the option. Despite that prefernce, fewer Greek citizens can afford paying for private care out of pocket or to continue paying for private health insurance policies.

Further information on Greece’s overall situation will be becoming shortly available in our Country Commercial Guide 2016 for Greece, which is in a finalization phase. CS/Athens however remains focused on supporting the healthcare industry on the issues of growing arrears towards pharmaceutical and medical device companies, on pricing situations involving data protection expiration, pricing of medical devices and laboratory equipment, and public procurement.


Market Entry

General

As a member of the European Union (EU), Greece applies the EU common tariff schedule on products imported from non-EU countries. All products, regardless of origin, are subject to the value-added tax (VAT), which is 24% for most products and 6% for pharmaceuticals.

Medical Equipment & Devices Sector

While duties are applied to components/parts of medical products and disposables, third country medical equipment (including U.S.), is not subject to import duties in the EU. Within the EU, medical device legislation is harmonized through the European Union’s Medical Devices Directive 93/42/EEC. This enables a manufacturer who has approval in one EU country to gain access to Europe’s entire market without having to obtain approvals from each additional country. All low-risk devices, which are in conformity with the requirements of the directive, must carry a CE mark. Higher-risk classified products must carry the identification number of the certifying organization that performed the conformity assessment and issued the approval in addition to the CE mark. Although instructions have to be provided in the national language, technical manuals and promotional material are acceptable in English, French and German.

Regardless of the recession, there are entities in Greece to drive eHealth forward. Additionally, the advancement of e-procurement in the healthcare sector, including electronic tender management, order management, inventory management, and innovative approaches to reducing bureaucracy, cycle times, etc. are amongst the priorities.

Best Prospects for U.S. Firms

Health IT

Below are some areas where U.S. firms may find opportunities:

  • Hospital procurement based on Electronic Data Interchange Systems (EDI)
  • Information system for transactions between hospitals and insurance companies
  • Smart health insurance cards
  • Information system for the national ambulance service
  • Information system for organ transplantation coordination and control
  • National blood-bank information system
  • Primary care information system
  • Medical libraries information system
  • Clinical information systems such as radiology information system; nursing information system; computer assisted diagnosis; surgery training and planning system
  • E-care & telemedicine, such as disease management and remote patient monitoring
  • Development of information systems to improve the services provided by welfare and mental health providers to the elderly and people with special needs
  • e-Prescription and e-Referral, e-Labs systems (inclusive of provisions for appropriate accreditation, testing and certification).

Medical Tourism in Greece

10-15% of patients from EU states seek healthcare abroad. Greece is a popular tourist destination in general with infrastructure and skills to attract patients/visitors from anywhere in the world, including Europe. However, current economic uncertainties and ongoing concerns over the refugee situation stand in the way of development of medical tourism.

Main Competitors

In the Greek market, there are approximately 300 companies in the medical device field. These companies are mainly importers and distributors of scientific and medical equipment and also provide after-sales services. Key suppliers of medical equipment to Greece are the United States, Germany, Italy and to a smaller degree, the Netherlands, France, United Kingdom, and Luxemburg. EU companies hold a major share of the Greek market due to their geographic proximity, product quality, and established marketing arrangements.

Domestic manufacturing has failed to continue developing and consequently focuses on low-value products such as bandages, gauze, and basic hospital furniture. The medical equipment market in Greece is highly competitive due to the large number of importers. The structure of the public healthcare sector, and especially the bureaucratic processes of the Greek tendering system, continues to make it imperative for small- to medium-sized U.S. suppliers to engage the services of local partners. Competitive strategies, particularly when dealing with public hospitals, focus mostly on pricing with the understanding that payment could take a year or more to receive. Leasing is also an option for certain categories of large, high-tech, expensive equipment.


Demand

Public health institutions (hospitals, health centers, and regional clinics) constitute 80% of demand. Private health Institutions (hospitals, clinics, diagnostic centers, and professionals) account for the rest, with individual consumers representing only a small segment of the market.

The market leaders in the private healthcare sector in Greece are Athens Medical Group, Euromedica, Hygeia Group, and IASO Group. These medical business groups had grown impressively, but over the last decade they have difficulty meeting operating expenses. Several smaller providers have closed as their doctors were no longer able to secure sufficient patient inflow needed to break even. Some groups have turned towards other markets in the region, such as Albania and Cyprus.

Barriers

There are no significant market-entry barriers in Greece, but the arrears situation is a major consideration.

Registration Process

For pharmaceuticals, FDA certification is not accepted by in the EU. Every product must comply with European standards. Companies interested in exporting to Greece should apply through their importing company to the National Organization for Medicines (EOF), indicating the country and the laboratory that produced the pharmaceutical and details about the drug. The company importing the U.S. pharmaceuticals should also have a specialized license to import pharmaceuticals issued by EOF.

There are no import restrictions for medical devices. However, there is a requirement for CE Certification (European Conformity), which can be provided by the authorities of any EU country and is accepted by all EU member countries.

Trade Events

8th Conference & Expo

Management Communication

& Scientific Conference on Pharmaceutical Care

February, 2017

Athens, Metropolitan Expo

http://www.pharmamanage.gr/

U.S. Commercial Service Contact Information

Name: George Bonanos
Position:
Commercial Specialist
Email:
george.bonanos@trade.gov
Phone
: +30 (210) 720-2331


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