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)
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Keywords
Δημόσια 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-ΠρομήθειεςAbstract
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.