Long Read: Greece – Back on Track?


After 15 years of economic struggles coupled with political swings to the left and right, Greece seems to be on its surest footing in decades. Indeed, the Economist observed that the May 2023 election victory of incumbent Greek Prime Minister Kyriakos Mitsotakis (and the heavy defeat handed to his left wing opponents Syriza which governed between 2015 and 2019) showed that “Greek voters have decided, by a whopping margin, that they prefer stability and technocratic competence to drama.” Mitsotakis’ centre-right New Democracy party obtained almost 41 percent of the vote, five seats short of a majority, while Syriza garnered just 20 percent.


The country’s healthcare and life sciences ecosystem also has some cause for optimism once more, especially in terms of its local generic manufacturers which helped steer Europe through COVID and now look set for further international expansion, in part thanks to a big injection of EU recovery grants and loans. However, the healthcare system remains chronically under-resourced, with overall funding still not back to 2009 levels. Moreover, the international innovative industry is sounding dire warnings about the system’s sustainability given the crisis-era levels of rebates and clawbacks which they must pay back to the state.


Macroeconomy: Solid Foundations

Greece’s economic and political struggles since the 2008 Global Financial Crisis are well-documented. In the decade up to 2019, the harsh austerity programme imposed by the ‘Troika’ of the European Commission, the European Central Bank, and the International Monetary Fund led to the country’s economy shrinking by a quarter, unemployment shooting up to 28 percent and half a million educated Greeks leaving the country in search of opportunities elsewhere.

However, despite ongoing global challenges, there is a much greater feeling of optimism around the Greek economy today. Indeed, the Financial Times recently named Greece one of the “seven economic wonders of a worried world” alongside India, Indonesia, Japan, Portugal, Saudi Arabia and Vietnam thanks to a significant increase in foreign investment and tourism numbers, a reduction in the percentage of nonperforming loans from 50 percent to under ten percent, and the rapid reduction of inflation.

“Greece is coming out of the COVID crisis quite strongly,” proclaims Novo Nordisk General Manager Olympios Papadimitriou, who also serves as president of the innovative pharma industry association, the Hellenic Association of Pharmaceutical Companies (SFEE). “We had an all-time record in tourism numbers in 2022 which ensured very significant GDP growth. At the same time, we must take geopolitical factors such as the energy crisis and war in Ukraine into consideration when we assess the country’s prospects.”


In essence, Greece has been on the tarmac and ready for a nice take-off since 2019, but this has not yet happened

Michael Himonas, SFEE


SFEE President Michael Homanas strikes a more cautious tone, summing up the ebbs and flows of the past few years thusly: “Greece finally exited its decade of government-debt crisis in 2019, but the positivity that this brought was short-lived, given that the COVID-19 pandemic hit the country in early 2020, and the fact that Greece is now facing an energy crisis brought about by the war in Ukraine. As such, GDP grew at eight percent for 2022, but this is heavily linked to inflation growth of 12 percent driven by the energy crisis. The economic outlook for 2023 is of a much more modest 2.3 percent GDP growth. In essence, Greece has been on the tarmac and ready for a nice take-off since 2019, but this has not yet happened.”

Aris Mitsopoulos from leading domestic manufacturer RAFARM is more positive. “The return of tourism has had an impact, but the whole economy is moving again. There is a substantial increase in investments, both from foreign and local actors, which is creating a rise in labour productivity and a reduction in unemployment. Moreover, structural reforms – including the digitalisation of the public sector – are already having an impact, and I am optimistic that the country’s growth momentum will continue.”

Looking back on the past five years, IQVIA General Manager Nikos Kostaras is cautiously optimistic. “Many things have changed, some for better, some for worse,” he states. “There is increased income from tourism, and the COVID-19 pandemic – while not a positive in itself – did lead to the creation of the European Union’s Recovery & Resilience Fund (RRF). Greece has the highest percentage of RRF in relation to GDP in Europe, meaning that a lot of new funds are coming online in the next few years.”


Healthcare: Funding Woes

This feeling of cautious optimism does not necessarily extend across the country’s healthcare system, where industry stakeholders complain of chronic underfunding ill-aligned to Greece’s economic recovery.

“Not only is public funding still not quite back up to pre-crisis levels, but it is even worse than it was in the first years of the crisis (2010-2013),” laments Papadimitriou. “Public spending was about EUR five billion in 2009, then it decreased to 3.5 billion and then to 2.8. But now, over the last couple of years, it fluctuates around 2.5 billion including both outpatients and hospitals.”

Significant results of this dearth of funding and planning include a drop in Greece’s life expectancy from a high of 82 in 2018 to 80 in 2020. Moreover, while the country does have an abundance of doctors in relation to its population, there is a severe lack of nurses, according to the OECD. Greece recorded the second highest level of unmet needs for medical care before the COVID-19 pandemic and while nearly 80 percent of Greeks report good health, 15 percent of adults also reported symptoms of psychological distress – far above the EU average of 11 percent. Indeed, Greece was recently ranked the most stressful country in Europe. Finally, the country dedicates comparatively little to long-term care – just 1.7 percent of total spending compared to the much higher share of 16.3 percent in the EU – while spending on preventive care (1.4 percent) is among the lowest in the bloc and well below the EU average of 2.9 percent.

For Kostaras, it is the lack of strategy on the part of the Greek authorities which is diminishing the effectiveness of the country’s healthcare system. “We still lack a strategic plan for healthcare,” he opines. “Many decisions are taken very slowly and even those that do not have a direct cost attached – such as clinical trial guidelines – have a knock-on effect on the country’s attractiveness. The lack of a holistic plan is a cause of understaffing in hospitals and the stagnant drug budget, hindering the market entry of new treatments.”


The lack of a holistic plan [for healthcare] is a cause of understaffing in hospitals and the stagnant drug budget, hindering the market entry of new treatments

Nikos Kosataras, IQVIA


Industry veteran Theodore Liakopoulos, managing director of J&J, is rather more sanguine. “Since 2017, the new government has made a lot of positive enhancements to healthcare system strategy and helped advance the quality of the products being introduced into Greek hospitals,” he begins. “We have seen a big effort in restructuring and reforming the healthcare system over the last four years, including the formation of a central procurement authority [a state Health Procurement Committee (EPY) has been re-established with the aim of formulating a plan to reduce procurement costs of medical devices and pharmaceuticals, improve payment time, make uniform medical requests, transfer redundant materials from one hospital to another and improve management of expired products – Ed.].”

He continues, “The regionalised and centralised tendering system is already creating greater transparency and ensuring that fewer low-quality products are introduced into the system. The government has shown that they are cognizant of this issue and are willing and able to do something about it, both in terms of pharmaceuticals and medtech.”

Ipsen General Manager for Greece, Cyprus & Israel George Carystinos adds that “Greece is a very compassionate and patient-centric market. The healthcare system strives to serve patients and to leave no one behind. It’s a market that wants to get new innovations in fast, which is a positive because it aligns with our ambition. Thirdly, we have an exceptional talent pool of deeply experienced professionals throughout the healthcare system.”

“There is a lot to be optimistic about in Greece,” notes Merck’s Susan King-Barnardo. “For example, the implementation of a digital app and vaccination certificate during COVID-19 worked very well. Moreover, Greece’s electronic drug approval system is fantastic.” However, she cautions that “to ensure a sustainable healthcare system moving forward, the high levels of returns that the industry is forced to pay back to the state need to be remedied. Healthcare is the only industry where prices fall and costs rise.”


A Challenging Market for Innovation…

For multinational pharma companies embedded in Greece, the sustainability of the current system is highly questionable, and many are now warning that future innovations may not even be launched in Greece at all. Under particular fire is the country’s clawback mechanism, originally enacted in 2012 under the first memorandum of understanding between the Greek government and the EU. Initially a temporary measure which took EUR 78 million in its first year, it has since been reinstated three times and become a more permanent fixture on the pharmaceutical landscape, surpassing EUR 1.36 billion in value in 2022.

Himonas does though highlight that “Greece performs well on the European Federation of Pharmaceutical Industries and Associations (EFPIA)’s Patients W.A.I.T. (Waiting to Access Innovative Therapies) Indicator which measures time to patient access across the EU and is generally quite good in terms of access to new medicines. This is because we have a government which accepts the introduction of new medicines and is willing to, at least partially, pay for innovation.” 54 percent of EMA-approved products were available in Greece as of the latest W.A.I.T. data compared to an EU average of 45 percent and putting Greece ahead of high-income Western European nations like Belgium, Norway, and Ireland.


Unpredictability, transparency, and sustainability have continued to be challenging

Agata Jakoncic, MSD


However, he cautions that “the good momentum that has been established in the last two or three years will not continue unless the way that mandatory returns are calculated and how the negotiation committee uses those mandatory returns changes. There needs to be a more pragmatic and realistic approach. The negotiation committee demanded a 47 percent discount on average in 2022, which is unworkable for pharmaceutical companies, especially those bringing forward highly innovative medicines. Additionally, Greece is not yet utilising tools seen in more modern reimbursement systems such as pay-for-results, outcome-based arrangements, and managed entry agreements.”

“Over the last decade, several important innovative treatments entered the market, but the government has not foreseen enough spending on pharmaceuticals to pay for this innovation,” states Papadimitriou. “At the same time the government, and not only the current one, is not willing to control spending, meaning overseeing the situation and creating restrictions and limitations for all stakeholders contributing to the demand. As a result of this, there is a steadily rising excess of the defined state budget over the years that is covered exclusively by the industry. Currently, the level of mandatory returns from the industry is probably the worst ever.”

“SFEE data for 2022 shows that discounts reached up to 70 percent in some cases either through automatic mandatory returns or directly through the contracts signed by the negotiation committee,” adds Antonino Biroccio, VP and GM at GSK. “This level of discount cannot be supported by the industry and can jeopardise the flow of innovative medicines and vaccines into the country, creating a barrier to patient access,” he warns.

Janssen’s VP and Managing Director for Greece, Poland & Romania Christian Rodseth has similar concerns. “We have reached the upper limit of what is bearable and are starting to see pharmaceutical companies making tough choices on not launching new products in the Greek market. This concerns me deeply because it means that patients who previously had access to innovation may not in the future.”

Drawing on his experience in Romania – a country that has reviewed its previously high levels of clawbacks – Gabriele Jannis, now GM for Angelini Pharma Greece & Bulgaria, is hopeful that the Greek state will eventually lend a more sympathetic ear to the industry’s arguments. “I am hopeful that – at some point – [the authorities] will start listening, either because they understand the problem or because reality has made them understand the problem,” he opines. “In Romania, I saw a similar situation with a government that was initially very reluctant to listen to our argument, which eventually became much more willing to engage in finding mutually advantageous solutions. There needs to be an understanding that, if we continue along the same trajectory in Greece, everybody loses. It is therefore better to try and understand one another’s needs and find solutions that do not lead to the disappearance of therapies from the market.”

Even with careful prioritisation and allocation of resources, MSD’s Managing Director for Greece, Cyprus & Malta Agata Jakoncic, who also serves as president of Greece’s PhRMA Innovation Forum (PIF), warns that companies like hers have had to choose not to bring certain products to Greece. “Firstly, early on, we determined where to invest, what to focus on, and what not to focus on,” she outlines. “Secondly, we carefully assess the access possibilities. This has become a critical factor in deciding whether to launch a product or not, because of the high austerity measures. So, while we have had success with some products, there are four products we have not launched.”

Additionally, Jakoncic feels that not only are the clawbacks and rebates being set at unsustainably high levels, they are also difficult to predict, putting Greek operations in further jeopardy. “Unpredictability, transparency, and sustainability have continued to be challenging,” she decries. “During my six years as MD for MSD Greece, the way austerity measures are calculated has changed annually. As of April 2023, we still do not have the final bill for 2022. We do not know what the bill will be for 2023, and soon, we will start planning for 2024. We have been operating for three years not knowing what our final numbers will look like.


We cannot be satisfied when patients in Greece are only able to access products much later than their European counterparts

Yvoni Papastelatou, Sanofi


Delays are taking their toll too. “While in my previous role as country manager for both Slovenia and Croatia I had the privilege of launching one of Merck’s latest innovative neurology treatments, unfortunately – due to the reforms that have happened in Greece – this product was not available for Greek patients when I arrived,” says King-Barnardo of the Germany-headquartered Merck Group. “Therefore, one of my first projects in this role was working to gain reimbursement for this treatment in Greece. While we were finally able to start supplying this product in Greece at the beginning of 2021, this was approximately three years later than other European countries.”

“Most of our products reach reimbursement with significant delays, ranging from many months if not years, compared to other European countries,” complements Yvoni Papastelatou, country lead & general manager specialty care for Sanofi Greece & Cyprus. “We cannot be satisfied when patients in Greece are only able to access products much later than their European counterparts.”


…And for Generics

Against the backdrop of a squeeze on the pricing of innovative products, one might assume that the Greek authorities would attempt to boost the participation of off-patent medicines in the market and drive savings. However, generic penetration stood at just 26 percent in Greece in terms of total market value in 2020, far behind Europe’s leading generics countries such as Italy (67.6 percent), Poland (58 percent) and Austria (49 percent). Moreover, industry insiders speak of a race to the bottom on generic pricing and perverse incentives which do not encourage generic switching. All of this is rendering profitability – and ultimately sustainability – a significant challenge.

“The absence of economic incentives for both the patient and the pharmaceutical supply chain, as well as insufficient administrative capacity to control the unjustified switching towards more expensive alternatives, explains the stagnant generic penetration levels,” highlights Faye Kosmopolou, general manager of the association of generics companies in Greece, the Panhellenic Union of Pharmaceutical Industry (PEF).


The main issue, in the retail market at least, is a lack of strict measures regarding consumption

Dimitris Demos, DEMO Pharma


“There are 80,000 doctors in Greece – one of the highest numbers per capita in the world – who are competing for clientele and are often willing to prescribe the most expensive medicines available to keep the same patients or gain new ones,” expands the SFEE’s Himonas. “The same results could often be achieved with a cheaper generic equivalent, but there is no incentive for doctors to prescribe such medicines. In other words, the mix is wrong, not the volume.”

DEMO Pharma CEO Dimitris Demos adds that “The main issue, in the retail market at least, is a lack of strict measures regarding consumption. Negotiations around new products have been insufficient in the past, and there are insufficient incentives for doctors and patients to switch to cheaper generic products.” However, he adds that “In the hospital market, on the contrary, the multi-sourcing tendering system, which is implemented for years, could be used as the gold standard for the whole EU, as has been proved during the COVID crisis, serving the Greek hospitals with zero shortages.”

In contrast, Evangelos Zekkas of fellow local player Help Pharmaceuticals feels the situation has actually worsened post-pandemic. “COVID-19 and the resulting disruptions in production and supply chain followed by considerable price increases in energy costs were added to an already troubled Greek pharmaceutical market, already stretched by low prices and clawbacks that currently exceed 40 percent on average,” he compounds. “The combination of low prices and high clawbacks has made several generic products non-profitable, which had to be withdrawn from the market.”

Several solutions are being proposed to remedy the situation. “70 percent of all prescriptions should be older generic and off-patent products with low prices,” proclaims Theodore Tryfon, VP of ELPEN Pharmaceutical and Co-CEO of ELPEN Group, who also sits on the board of continent-wide off-patent association Medicines for Europe. “There should be clear prescription guidelines for doctors on this and incentives for pharmacists. We have seen some progress from the government, in collaboration with PEF, but more needs to be done. No country, especially one with as large a debt as Greece, can pay for all these new products without creating space by switching to older ones.”


EU RRF Funding: A Welcome Boost

Greece has a complicated relationship with the EU stemming back to the harsh austerity measures imposed during the crisis years. However, there are significant hopes that the EUR 70.5 billion post-COVID Recovery & Resilience Fund (RRF), EUR 1.5 billion of which has been specifically earmarked for healthcare, could go some way to reshaping the system for the better. EUR 278 million will go towards digital upgrades, EUR 317 million for hospital upgrades, and EUR 271 million for primary care.

“As I see it, there are three easy wins for this RRF funding,” begins J&J’s Liakopoulos. “Firstly, this money can be used to speed up the much-needed implementation of digital transformation across the board. Secondly, it can help increase the level of human resources in public hospitals. Thirdly, there is space for this funding to help improve the digital infrastructure in public hospitals. There is a significant need for interconnection within the public healthcare system, both between hospitals and between primary and secondary care. A well-designed digital patient record system that tracks patients needs to be established.”

“This funding injection has the potential to make the biggest difference in primary care,” adds Himonas. “A more efficient primary system would see patients visit hospitals far less, thereby significantly reducing the expenses incurred by the state.”


A well-designed digital patient record system that tracks patients needs to be established

Theodore Liakopoulos, J&J


Of particular interest to the pharmaceutical industry is a commitment from the Greek government to gradually reduce the clawback levels under this RRF funding. “With 2020 as the baseline, the clawback must be EUR 50 million less than 2020. In 2023, it must be EUR 150 million less than 2020. In 2024, it must be EUR 300 million less, and in 2025, it must be EUR 400 million less,” according to MSD’s Jakoncic.

“At least some of the funds from RRF should be used to reorganise pharmaceutical expenditures,” adds Help Pharma’s Zekkas. “No particular care has been given to the pharmaceutical budget over recent years to accommodate for the significant introduction of new medicines, increased prescription needs due to the ageing population, or rising costs.”

“We hope that more funds will be channelled into our sector, given that at least 50 percent of medicines are currently paid for by pharmaceutical companies and not by the government,” agrees Nicos Ragoussis, managing director of Danish mid-cap dermatology specialist LEO Pharma’s operations in Greece, Cyprus, and Albania. He adds that companies themselves will need to adapt to benefit from the RRF influx. “Putting extra money into the system is by no means a cure-all, as other things need to happen as well − and are happening− for example, investment programs to build new manufacturing sites in Greece, clinical trial funding, and other initiatives. Funding is channelled to those projects rather than to medicines per se. Therefore, for us to reap the benefits, we have to become involved in these activities.”


Boom Time for Local Manufacturing

Perhaps the most important impact of Greece’s RRF funding will be the clawback offset it offers to firms engaged in pharmaceutical manufacturing in Greece, a sector that already represents EUR 2.8 billion of Greece’s annual GDP with 11,000 direct employees and 53,000 additional jobs. Local manufacturers’ ebullient representatives are already playing up the country’s potential to become an essential medicine production hub for Southern Europe and beyond.

“Policy reform around the clawback offset adopted under RRF has allowed our industry to unlock an investment plan amounting to EUR 1.2 billion,” exclaims PEF’s Kosmopolou. “This investment will update the capacity of the Greek manufacturing industry, ensuring patient access to affordable and high-quality medicines and also contribute to Europe’s strategic autonomy in pharmaceuticals,” she adds. “Moreover, Greece is the only European country to have included the pharmaceutical industry within its RRF plan, which will allow the inflow of new funds into the country and lead to the opening of 12 new manufacturing sites, 16 new R&D facilities, and 32 new manufacturing units.”


It is now once more an attractive proposition to invest in Greek manufacturing and regain some of the momentum lost in the previous decade

Theodore Tryfon, ELPEN


As Tryfon of ELPEN – a well-established local generics manufacturer with a specialism in inhalable products – proclaims, “It is now once more an attractive proposition to invest in Greek manufacturing and regain some of the momentum lost in the previous decade. Greece has a strong manufacturing base with 45 production units – one of the largest per capita in Europe – as well as highly qualified personnel.”

“The RRF is already influencing our investment plans” says Demos of DEMO, an injectable generics player which accounts for a full 25 percent of total investment across the entire Greek pharmaceutical sector. “DEMO is receiving long-term funding, contributing to the added-value development of Greece’s and Europe’s manufacturing sector. We are building up our production capacity, including a new manufacturing campus in the industrial zone of Tripoli, 120 km from Athens, which will entail the expansion into the manufacturing of different chemical forms as well as our own active pharmaceutical ingredients (APIs).”

RAFARM’s Mitsopoulos tells a similar tale. “The RRF clawback offset for manufacturers has led RAFARM – building on its existing investments – to add significant new capacity in ophthalmology and become one of the top European ophthalmology manufacturers, growing from the current 25 million units per year in this niche to 45 million.” The company’s production site has been FDA-approved since 2018 and RAFARM already has six products in the US market with development and registrations for a further 15 new abbreviated new drug application (ANDA) filings ongoing.

With the COVID pandemic – during which these Greek manufacturers were able to maintain supply to both national and international markets – in the rear-view mirror, there is a growing sense that this could be the nation’s opportunity to establish itself more fully as a European manufacturing stronghold.

“We believe that Greece can become the hub for Southeast Europe in pharmaceutical R&D and production,” boldly claims Kosmopolou. “This potential was clearly displayed in Greece’s response to COVID, when all our pharmaceutical manufacturers embraced a collective spirit of solidarity. Our sector was able to ensure uninterrupted coverage for more than three million patients, which underlines the advantages of having a strong pharmaceutical manufacturing industry. Unlike other EU member states, Greece did not face medicine shortages but was able to safeguard supply and even export to larger countries like the UK and Germany, which were heavily reliant on imports from low-cost suppliers in China and India.”

“Southern Europe is now repositioning itself in relation to Northern Europe,” adds Demos. “Over the past 20 years, many EU grants were given towards areas such as innovation and IP protection, while generics were outsourced to countries like India, Turkey, Pakistan and other low-cost producing countries. However, today, local manufacturing companies from Italy, Spain and Greece have a competitive advantage to supply products to the EU. Southern Europe could undertake the production of generics while Northern Europe concentrates on producing innovative products.”

“It is the perfect time for Southern Europe, not only Greece, to play an important role in safeguarding the resilience and stability of the EU in terms of pharmaceuticals. This was also our main point of negotiation with the European authorities during the crisis period. Sufficiency in three key areas – energy, food, and pharmaceuticals – is crucial for a country or region’s survival and ability to traverse economic hardship.”

“Europe has realised that it has been too dependent on imports and can easily experience shortages of vital products,” confirms Mitsopoulos. “We are therefore seeing a political shift from the EU towards establishing a more supportive and robust pharmaceutical manufacturing ecosystem within Europe. This is crucial both in economic terms as well as on health security grounds.”


Moving up the Value Chain?

There is also hope that this boom in local manufacturing can help propel Greek pharma up the value chain in other areas. RAFARM’s Mitsopoulos highlights his company’s focus on “incremental innovation,” stating that “Differentiation is a key driver of our growth: we develop and produce products with incremental innovation—for example, alternative dosage forms, new formulations and combinations— opening a path to profitable growth.” For Demos, biosimilars will be the next frontier, adding that “DEMO is building a new facility for this field which also covers the production of monoclonal antibodies and is slated to be finalised by the end of 2023.”


Differentiation is a key driver of our growth: we develop and produce products with incremental innovation—for example, alternative dosage forms, new formulations and combinations— opening a path to profitable growth

Aris Mitsopoulos, RAFARM


ELPEN, for its part, is working to create a biotech startup incubator at the Athens LifeTech Park, providing preclinical trial contract research organisation (CRO) services to large companies, and focusing heavily on research and education activities. “Through the Athens LifeTech Park ELPEN wants to be a major part of the Greek research ecosystem, collaborating with academia, research institutions, and highly qualified professionals, both in Greece and abroad,” outlines Tryfon. “There is a strong network of high-calibre pharma and biotech leaders of Greek origin in the US, many of whom want to contribute to their home country through research collaborations.”

There is also hope that multinational companies will begin to participate more broadly in Greece, building on the examples of Pfizer – whose data hub in Thessaloniki employs over 750 people – and Boehringer Ingelheim – currently the only global firm with manufacturing operations in the country. AbbVie and Bayer are two other pharmas that have made significant recent investments in Greece, for a clinical trials hub and clinical trials academy respectively.


Finding the Way Forward

The future prospects for Greek healthcare and the life sciences are, therefore, a mixed bag. The country’s relative political and economic stability is cause for cheer, as are domestic manufacturers’ triumphs and the potential for EU RRF funding to upgrade the healthcare system. However, as industry stakeholders across the board have pointed out, so long as Greece remains wedded to a crisis-era system with high levels of clawbacks and rebates, it will struggle to emerge as an innovation-friendly market, scale the value chain in terms of R&D, and bring cutting-edge therapies to its patients.


The main challenge will always be resistance to trying to innovate the future of healthcare

Spyridon Gkikas, GE HealthCare


Practical changes have been proposed. “In 2020, we put our heads together to establish a roadmap for sustainable and effective pharmaceutical care in Greece,” outlines Jakoncic of MSD and PIF. “It contains five elements: a stable and predictable pricing and reimbursement system; a more transparent and efficient HTA system; the empowerment of clinical and biomedical research and funding for innovation; transparency and monitoring prescribing, implementing clinical protocols and registry implementation; and sustainable and predictable financing. With this ambitious five-step roadmap, we want to remove all the protectionism away and start from scratch.”

“We are asking the government to take a two-pronged approach,” adds Himonas. “The first prong is to increase spending gradually from its very low levels to cover the needs of the population. The second prong is to manage spending and reduce wastage within the system. Greater efficiency can be created by utilising already-available digital tools, registries, protocols, and enforcing greater control overall by the authorities.”

Overall though it is a psychological as much as practical adjustment that is most needed. In the words of GE HealthCare’s General Manager for Greece & Cyprus Spyridon Gkikas, “The main challenge will always be resistance to trying to innovate the future of healthcare. This resistance can come from bureaucracy, old mindsets, or poor practices of the past, and will not be easy to change, but we must push for this to create a world where care has no limits.”

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