Individuals' personal characteristics associated with private health insurance policy possession in Greece.

BACKGROUND: Possession of private health insurance has been associated with personal and socioeconomic characteristics, such as income and age. The objective of the present study is to assess the individuals' personal characteristics associated with private health insurance possession in Greece. METHODS: The data used in the present analysis derived from the 'Health and Welfare' survey conducted by the Hellenic National School of Public Health in Greece and refer to year 2017. The sample of the analysis consisted of 1,932 adults aged 18 years or older. Α binary logistic regression model was conducted, in order to investigate the factors associated with private health insurance possession. RESULTS: The factors that were found to be associated with private health insurance possession were: area of residence; Attica, family income level; 1,501€-2,000€, 2,001€+, absence of chronic condition, occupation; employer/self-employed, absence of public insurance, time since last health check-up; less than or equal to 5 and more than 1 years ago, more than 5 years or never and level of education; secondary, tertiary. CONCLUSIONS: Private health insurance covers a low percent of the Greek population and has a low contribution to private health spending, compared with other countries. The personal characteristics that were found to be associated with private health insurance possession in Greece by the present study are in line with previous studies in other countries. These results are expected to provide policy advice on how to enhance coverage in order to reduce out-of-pocket expenditure, which is considered high in Greece.

A 10-year economic analysis of HIV management in Greece: evidence of efficient resource allocation.

OBJECTIVE: Human Immunodeficiency Virus (HIV) prevalence has substantially increased over the years, leading to increased direct medical costs. The aim of the present study was to assess the long-term cost of HIV care in Greece incurred over the last decade. METHODS: In order to assess the long-term cost of HIV care, a cost analysis was undertaken for three discrete time points (which reflect major changes in the HIV treatment paradigm), incorporating the evolution of the cost of pharmaceuticals, hospitalization, primary care visits and diagnostic tests. The cost per life year gained (LYG) was also estimated. RESULTS: Total cost of HIV care increased by 57% over the last decade (€53.7 million in 2010 vs €84.5 million in 2019), which can be mainly attributed to a 107% (5084 in 2010 vs. 10,523 in 2019) increase observed in the number of people living with HIV (PLWH) under care. As a result, the cost per person on treatment has decreased by 24.0% (€10,567 in 2010 vs €8032 in 2019). Lifetime cost was lower and life expectancy higher in 2019 compared to 2010, leading to a - €711 cost per LYG, suggesting that the current treatment paradigm produces better health outcomes at a lower cost compared to a decade ago, implying that resources are used in a more efficient way. CONCLUSION: The paper presents some evidence towards the direction that HIV management in Greece can be considered efficient in both clinical and financial terms, as it offers measurable clinical outcomes at well-controlled, almost inelastic spending.

Self-medication in Greece: the financial impact from expanding the OTC market.

OBJECTIVES: To assess the financial impact of self-medication enhancement through a potential expansion of the over-the-counter (OTC) drug list in Greece. METHODS: An analysis consisting of two scenarios was conducted. The first scenario estimated the financial effects of hypothetically switching 5% of the volume of the total sales of reimbursed drugs in Greece to OTC, while the second scenario estimated the effects of switching to OTC the total sales volume of a set of active substances (which are currently reimbursed), facilitated by a consensus panel meeting. The analysis was conducted from the third-party payer, individual and societal perspectives. Data and costs refer to the year 2019. KEY FINDINGS: Switching 5% of the volume of the total sales of reimbursed drugs to OTC was estimated to lead to total annual savings of 227.57 million euros. The annual savings from the third-party payer, individual and societal perspectives were estimated at 97.06 million euros, 91.81 million euros and 38.69 million euros, respectively. Switching the total sales volume of the reimbursed drugs of the active substances which emerged from the consensus panel meeting was estimated to lead to total annual savings of 567.57 million euros. The annual savings for the third-party payer, individuals and society were estimated at 232.91 million euros, 241.01 million euros and 93.65 million euros, respectively. CONCLUSIONS: Although the present analysis is model-based, and thus did not incorporate some potentially significant parameters, it demonstrated the financial savings which a potential expansion of the OTC drug list could produce for the third-party payer, individuals and society in Greece.

Cost-Benefit Analysis of Single versus Repeated Use of Single-Use Devices in Cataract Surgery.

PURPOSE: To estimate the net cost effect associated with the real-world practice of repeated use of designated single-use medical devices (SUDs) versus their proper single use in cataract surgery in Greece. DESIGN: A cost-benefit analysis model was constructed in the form of a decision tree. METHODS: A digital expert panel was assembled in order to estimate the probabilities of intraoperative and postoperative complications associated with single and repeated use of SUDs. Unit costs for the management of each complication were obtained from the official Greek bulletins. A Monte Carlo-type sensitivity analysis was performed to assess the robustness of the results. RESULTS: Based on the probabilities of complications attained from the expert panel, repeated use of SUDs is associated with a higher chance of complications compared to single use, which results in higher cost of complication management. Under the healthcare sector perspective, the total expected cost per cataract surgery is 1,403.98€ (1,244.20€ the initial cost of cataract surgery plus 159.78€ the cost of adverse events) in the case of single use, while for repeated use the total cost is 1,486.29€ (1,146.86€ + 339.43€, respectively) and, thus, repeated use of SUDs in cataract surgery results in 82.31€ higher expected cost per patient compared to their single use. Moreover, the societal perspective analysis indicated even higher additional costs in the case of SUD reuse (108.24€). CONCLUSION: Repeated use of SUDs in cataract surgery is not appropriate, it jeopardizes patient safety and carries a legal liability for the reuser. The present study, which is the first to attach a monetary value to the common yet questionable practice of SUD reuse, shows that it is not cost beneficial. Therefore, it is expected that the results will have implications in policy formulations to improve the delivery of cataract healthcare.