Knowledge is power. This position also applies in the case of the General Health System for the beneficiaries. Each of us must know both the obligations and the rights provided to him by the System, so that he can use it properly in every case.
One of the most important reforms brought by the implementation of the GESS was its establishment Catalog of Medicinal Products which allowed doctors and beneficiaries access to an extended list of drugs, which are reimbursed by the System, with the beneficiary having -in most cases- only the obligation to supplement.
From the beginning of the establishment of the drug list, the System included together with the original drugs and the corresponding generics or interchangeable, so that each category of drug has even one formulation only with the payment of supplement. The ultimate goal was to give the beneficiaries a choice in order to avoid, if they so wish, the additional financial contribution.
However, during the operation of the System, it was observed that in several cases the beneficiaries were unaware of this right. As a result, when they arrived at the pharmacy cash register, they were asked to pay an additional amount, in addition to the supplement, for preparations that were cheaper to exchange in the GESS list.
Even today, one of the most frequently asked questions of the System concerns the changes of the pricing, with the beneficiaries declaring ignorance as they leave their information at the discretion of the respective doctor or pharmacist they consult.
Changes in drug prices
Changes in drug prices are usually made once a year by the Ministry of Health, increasing or decreasing the price. In any case, the System is updated, with doctors and pharmacists having access to this information so that they can work for the benefit of the beneficiaries. Changes in the pricing of some drugs may occur over time, with the System again being informed in a timely manner.
The doctor or pharmacist is obliged to inform the beneficiary about the changes in the pricing as well as to suggest the cheapest medicine of the category in order to avoid the Contribution II.
The noticeable difference between "Supplement" and "Contribution II"
Although 21 months have passed since the implementation of the System, it is necessary to fully understand the difference between Completion and Contribution II, which the beneficiary is required to pay for the purchase of his medicines, as the case may be.
GESS fully reimburses the cheapest available drug on the list, with the beneficiary paying 1 euro for each drug listed. In case two boxes of the same medicine are prescribed due to increased dosage again the beneficiary will pay 1 euro. This amount is intended to reduce unjustified waste. Precisely for this reason, this amount is low, while there is also the annual supplementary ceiling (The ceiling includes the supplement paid by the beneficiary when receiving all services from GESS) and which is set for the general population at € 150 while for the low-income pensioners, the recipients of EUE aid and for children up to 21 years old at € 75.
Η Contribution II on the other hand, it works differently, as it is required in cases where the doctor prescribes another medicinal product, more expensive than the cheapest in its class. In such a case the beneficiary is required to pay the cost difference between the cheapest drug, from a category of drugs, which fully covers the GESS and the drug that has been prescribed.
Ask to know your alternatives
One of the biggest problems identified in the smooth operation of the System, concerns the ignorance of a portion of beneficiaries - as to their choices - in relation to the variety of drugs available to them. The beneficiary, always in consultation with his doctor, must have a role in choosing the medication he will receive. Certainly not in which treatment is best for him, but for the preparation that he will eventually receive from the pharmacy.
The GESSY Pharmaceutical Products Catalog is extensive and covers a wide range of products from original to generic / interchangeable medicines. All the drugs included in the List of Pharmaceutical Products of GESS are approved and have been tested both for their safety and for their effectiveness. The respective Personal or Specialist Doctor or pharmacist must inform the beneficiary of his choices, especially those that require the payment of an additional amount of money by the beneficiary.
In cases where this does not happen, ie if there is no information from the doctor, the beneficiary can ask his pharmacist to inform him about the changes in pricing and at the same time list his options for interchangeable drugs. The beneficiary has the right to request the cheapest medicine from his doctor or pharmacist, without doubting its quality and effectiveness.
It is important to mention that the same is true in cases of patients with chronic diseases who take certain medications. If during the year the beneficiary finds that the price of the medicine he is taking has changed, either upwards or downwards, then he must be informed about the difference in price and at the same time be aware of the alternatives he has in the same category. drug. He can receive this information by asking his pharmacist or doctor or by contacting the GESS Service Center by calling 17000.
The pharmacist is entitled to change the original formulation
Many beneficiaries believe that the pharmacist does not have the right to replace the medicine prescribed by the doctor, so they avoid asking for it when a Contribution II occurs (in addition to the supplement). It is important to mention that for each category of drugs included in the pharmaceutical list of GESS, there is at least one formulation, for which the payment of Contribution II is not required and can be obtained by paying 1 euro. The pharmacist can replace the prescription with a cheaper one, as long as the new formulation has exactly the same active ingredient as the original drug. If the cheapest product contains another substance, then the patient can contact his doctor to investigate the possibility of prescribing the cheapest product.
What about generics
A myth that, unfortunately, has prevailed widely, concerns the quality and effectiveness of generics, with a large portion of beneficiaries avoiding them for fear of "ineffective action".
This is a completely unfounded claim as well generic drugs are essentially the same as the originals and are available after the original drug has lost its exclusive production and marketing patent. They are subject to the same strict production and import controls like the original products, they are just as safe and effective and are constantly monitored, just like the original drugs, in terms of the occurrence of side effects.
Generic drugs, therefore, are considered therapeutically equivalent and interchangeable with their original. In addition, the GESS list includes only licensed medicines whose quality, safety and efficacy have been documented.
The reason that in some cases generic drugs are suggested or preferred concerns only the saving of resources. The savings achieved by GESS in this way are used to reimburse new drugs that are increasingly costly, due to the new technologies used for their production, as well as to meet the growing demands due to the aging population.