Well in the pharmacy, deep red in the hospital. Expenditure on State-paid drugs archives a 2009 double face. Under the expenditure ceiling in pharmaceuticals with a potential saving of 428 million (net of the payback paid by the industries) and down by 1.7% on 2008. But with a deficit of 1.7 billion for hospital pharmaceuticals, all at the expense of the regions. The AIFA (Medicine Agency) board of directors concluded yesterday the examination of pharmaceutical consumption in 2009, confirming all the critical points of the sector, which is not by chance at the center of a table of reforms. Among all, that of a regional nature which calls for a change in precisely that aspect – hospital-hospital consumption, driven by innovative drugs – which conditions their ability to rein in a part of the health care expenditure which it is up to them to repay.
For Aifa, the 2009 result was positive, at least in terms of consumption in pharmacies on which it has the chance to intervene. All the more so since the result was achieved after the ceiling was reduced from 14 to 13.6 per cent of the entire health expenditure only in the middle of the year. «Our control room worked», comments the president of Aifa, professor Sergio Pecorelli. However, it signals all the difficulties in the hospital where there is "the pulp of pharmaceutical innovation". But, Pecorelli considers, «once the drug becomes "mature", the innovation could also be partially transferred to the territory with an all-round evaluation and no longer parceled out between the parties». Aifa, among other things, with the HTA (health technology assessment) which it is developing with more personnel and specific skills, could give fundamental help.
I consumi in farmacia sono stati altalenanti. Ma un dato di fondo: l’aumento del 3,5%delle ricette. Segno, ha rilevato anche Federfarma, che si prescrivono più farmaci ma di prezzo più basso sia per l’irrompere dei generici che per il taglio dei listini: il valore medio di una ricetta è sceso del 4,5 per cento. Altro dato rilevante l’incidenza dei ticket, soprattutto nelle regioni con piani di rientro dal deficit: gli italiani hanno pagato di tasca propria 862 milioni, il 32,5% in più (211 milioni) sul 2008. La spesa in farmacia ha registrato le diminuzioni più vistose in Calabria (-6,1%), Lazio (-5,7) e Sicilia (-4,5); in Puglia (+ 2,2%)invece l’aumento più significativo.
The data on compliance with the expenditure ceiling (13.6%) is also eloquent: the average was 13.2% net of the payback. The bar was exceeded by all the regions with a deficit and in the entire south, except Basilicata. Lazio is at the top (15.5%) with seven other regions above the maximum expenditure ceiling, the lowest value in Bolzano (9.8%).
If spending in pharmacies is holding up to the shock wave of prescriptions, in hospital outgoings for drugs (without vaccines) have exploded: with 4.189 billion (net of the
pay back) of total spending, the red was 1.725 billion. The ceiling stood at a national average of 4.1% (against the threshold of 2.4%). All regions have exceeded the hospital ceiling, from the maximum in Umbria (+6%) to the minimum in Molise (+1.1). The category with the highest incidence of hospital expenditure is represented by monoclonal antibodies (513 million, 8.2% of the total) and tumor necrosis factor alpha inhibitors (406 million, equal to 6.6%). Fifteen categories alone are worth 52% of total hospital pharmaceutical expenditure.
The News of the Sole 24 Ore – 08/04/2010 08:15:18
