The Ministry of Health is evaluating an increase of approximately half a percentage point 700 million eurosof the resources allocated to pharmaceutical spending by the National Health Service, thus bringing the share to 15.8% of the National Health Fund, compared to the current one 15.3%. A change that is expected in the next budget, to be approved by October 20, to try to contain constantly growing pharmaceutical spending, which could further aggravate the already critical financial situation of the healthcare system.
How much will the spending be in 2024
The Government’s idea comes after the alarm raised byAifathe Italian Medicines Agency, which at the beginning of the month released data for the first two months of 2024: spending on medicines has already reached 4.093 billion eurosexceeding the current limit of 15.30% by 710 million. Same story happened in 2023, when the expense had arrived at 21.766 billion euros, with an increase of 6% compared to the previous year.
This increase is mainly due to growing demand for care by an aging population, highlighted by the 40% drop in mortality from the main pathologies in the last 20 years, also thanks to the introduction of innovative drugs, increasingly effective but also expensive. If this race continues, it is estimated that by the end of the year we could reach a record figure of 24 billion, equal to 18.5% of the health fund. “It is to be hoped that, faced with a continually aging society and such marked innovation, the fund allocated to pharmaceutical spending will be increased”, explains Government Undersecretary for Health Meloni, Marcello Gemmato.
The Government’s moves
A situation that is also worrying the Regions, which in recent days sent a letter to AIFA, to the Minister of Economy and Finance Giancarlo Giorgetti and to the Ministry of Health to report the “alarming projections” relating to 2024 spending. In particular, they requested an analysis of the impact deriving from the first transfer of some medicines from direct distribution (hospital) to affiliated distribution (pharmacies). For this reason, the Government is thinking of increasing the spending ceiling, which would go from 15.3% to 15.8% with the 2025 Budget.
The cap includes two distinct limits on pharmaceutical spending: that hospital, currently set at8.3% of the Health Fund, and that of pharmacies, equal to 6.8%as well as 0.2% for medical gases. The hospital ceiling is always in deficit, with an overshoot of over 3 billion in 2023, while that of pharmacies has a surplus of around 900 million in the same year. Exceeding the first limit also involves an increase in the so-called hidden “tax”. paybacka contribution that pharmaceutical companies are forced to pay every time the established spending limit is exceeded. For 2023, for example, companies in the sector will have to bear a cost of 1.64 billion euros.
For this reason, an increase in spending ceilings would represent an important support for pharmaceutical companies, as it would help reduce their share of payback, currently borne by half of them and half of the Regions. “I believe that the real challenge is to continue to maintain the sustainability of the National Health Service and offer new therapies to everyone. But new therapies are expensive,” the Minister of Health Orazio Schillaci recalled in recent days.
Where the additional funds will go
But how will this 0.50% increase in pharmaceutical spending be used? As in the past, it is expected that the adaptation will mainly concern the first roof, that of the hospital expensewho is always in difficulty. On the other hand, the Ministry of Health, thanks to the surplus of the second roof, began last year to transfer some medicines from hospital distribution to pharmaceutical distribution, to facilitate citizens’ access to therapies, making them more available close to home (started with some diabetes medications).
This first transfer moved approx 130 million from one roof to another, and by March 30th, AIFA and the Ministry of Health should announce the inclusion of new drugs to be transferred to pharmacies, for a similar amount. The Regions have requested greater clarity from the Medicines Agency on this process, since the leftovers from the second cap, relating to medicines sold in pharmacies, are allocated to the regional coffers.
