Bulgaria’s accession to the eurozone is set to feed into Greece’s drug-pricing system, though any near-term impact is expected to be limited. The country will be added to the eurozone reference basket used to set prices, which are calculated on the basis of the two lowest benchmarks.

With a general re-pricing completed last December, medicines already on the market are unlikely to see changes in 2026. Any effect is expected to be felt mainly in new medicines, where Bulgaria’s low-price profile could exert mild downward pressure.

Market players nevertheless downplay the scale of the effect. The president of the Hellenic Association of Pharmaceutical Companies (SFEE), has noted that while Bulgaria’s entry will factor into the pricing “basket” for new products, the resulting differences are not expected to be significant, at least for 2026.

The broader concern, however, extends beyond prices to patient access. Greece already has some of the lowest drug prices in Europe, combined with exceptionally high mandatory rebates and clawbacks imposed on pharmaceutical companies to stay within tight public budgets. As a result, only about one in five medicines approved by the European Medicines Agency (EMA) and the European Commission ultimately reach Greek patients—and often not fully or promptly.

Industry sources point out that pricing pressures are intensifying across the EU, with countries such as France and Germany also adopting clawback mechanisms. Even so, Greece remains an outlier: while new mandatory rebates elsewhere can reach up to 25%, clawbacks in Greece have climbed as high as 83% in some cases, averaging around 50%.

These pressures are increasingly linked to availability gaps, particularly for innovative therapies. According to recent IQVIA reports, just 20% of innovative medicines approved between 2021 and 2024 are currently available in Greece, with nearly half unlikely to reach patients in the foreseeable future. Delays are also widening, especially for oncology and orphan drugs, underscoring a growing tension between cost containment and timely access to innovation.