Νομικό πλαίσιο προμήθειας νοσοκομειακών φαρμακευτικών σκευασμάτων στην Ελλάδα και στην Ε.Ε.
Legal frame of commissions of pharmaceutical material for hospitals in Greece and in the European Union (E.E)
Μωυσάκος, Νικόλαος Σ.
AdvisorΔελούκα - Ιγγλέση, Κορνηλία
KeywordsΔημόσια νοσοκομεία ; Νομικό πλαίσιο προμηθειών ; Δημόσιες συμβάσεις ; Ηλεκτρονικοί πλειστηριασμοί ; Σύμβαση - πλαίσιο ; Ε.Π.Υ. ; Υ.Πε ; Legal framework supply ; Public procurement ; Electronic auctions ; Framework contracts ; Committee for health supplies ; Health region ; e-Προμήθειες
Throughout time, regardless the level of financial growth and prosperity of a country, matters such as the equal access in health services which offer quality, organization and financial efficiency are among the most important concerns of the citizens as well as the governments’ which form their healthcare policy each time. The remedy as a means of practice and provision of healthcare is an important social and financial good and this fact makes its management substantially difficult. In global as well as in national level, the field of hospital medication, its commission and management has become the centre and one of the most important and weighting factor which influences the proper function and provision of efficient health services on behalf of the hospitals. The European Union (from now on E.E) has established a series of directives which regulate the procedures of making public contracts, provisions of goods and by extension material for the hospitals. These directives were either adopted from the member states as they were or passed into the national legislation of the states many years now. In Greece, although the community directives have already been assimilated in our national legislation (2004/18/ΕΚ, 17/2004/ΕΚ and 2014/24/ΕΚ) through the Presidential Decree 118/07, Presidential Decree 60/07 and the Law 3861/2010, we observe that until recently the legal procedures for the material for the hospitals are not applied. The provisions of the public hospitals occur mainly by a selective application of the current legislation and with procedures which are on the verge of being considered illegal. Lack of material for the hospitals, huge stock up in the stores and expired medicines are a common phenomenon of the current health system due to afore mentioned. The problems already mentioned and the need for rationalization of the cost of the hospitals have led Greece to attempt recently to adjust to the community directives and apply clear and predefined procedures in the commission of the medicines .The result of this attempt was the reformation of the National Health System with the establishment of the E.Π.Υ (Committee of Health Commissions) (Ν. 3580/2007) and the specification of the IT-based auction (Ν. 3846/2010) as the main procedure for the commission of the medicines. A procedure, which in its present form and after a lot of modifications, has positively contributed in the achievement of especially low prices. Therefore, many and diverse problems as well as malpractices have been noticed during the IT-based auctions and the general results although can be characterized positive, they cannot have the necessary effect. The present dissertation will attempt to give a global picture concerning the tender procedures that are being followed for the commission of the medicines in the public hospitals of the country, in the E.E as well as the results that have been achieved through these procedures. Initially, what medicine means will be clarified as well as their different kinds which are the object of the contracts. Specifically, the definitions of the prototypes, the generics, the COMP medicines will be analyzed in order for the analysis of the frame of their commission to be easily perceived. Then, in chapter 2, the basic principles and the laws concerning the public commissions will be presented. Principles such as the technical specification, the framework agreement, the contract, the manifest, the award criteria and many more must be fully perceivable in order for a further and deep analysis of the topic to be possible. The third chapter shows particular interest since it includes a reference of the respective legislation of commissions in hospitals in the countries of the E.E but the further study of specific states of the E.E. In the fourth chapter follows the analysis of the national frame of the commissions in the hospitals and the body that takes part in the completion of the procedures, while at the same time it is presented and analysed the last act of IT-based auction with its supplements. Then, in chapter 5, the data concerning the prices of medicines coming from the first three IT-based auctions are presented as well as the pharmaceutical expenditure per hospital for every healthcare region. In chapter 6, the last one, the advantages and disadvantages of the auctions will be presented along with the various illegal actions which have been noticed occasionally while in the end some suggestions for the improvement of the current legal framework of commissions will be presented.