Loredano Days
An agreement must be signed with the doctors which aims to regain control of pharmaceutical expenditure, without which there is a risk of collapsing the entire system. The hope comes from Loredano Giorni, manager of the pharmaceutical sector in Tuscany, member of the AIFA price committee but above all eminence grise of the Government-Regions table who has been keeping an eye on drug spending since January, as required by the Stability Pact of territory and hospital. With the maneuver at the end of July in force, Doctornews went to knock on his door to ask his opinion on the measures imparted by the text and their economic impact.
Let's start with the Maneuver: the final judgment after the changes to the decree given by the conversion law?
“As it stands, the text is disappointing. The round table on spending had defined a package of interventions that started from three observations: first, in Italy the price of innovative medicines is lower than in the rest of Europe; second, still in Italy the price of off patents is higher than in the rest of Europe; thirdly, the final price of the medicines paid by the NHS weighs on the cost of distribution (wholesalers and pharmacies, ed.) higher than in other countries. In the conversion law those interventions were watered down, weakened».
In the meantime, however, by appealing to those measures, the Maneuver cuts you 600 million from the 2011 loan. Is there a risk that the accounts won't add up?
«I am more afraid of the structural growth of pharmaceutical spending. The territorial area grows on average by one-two percentage points a year, the hospital one by more than 6-7%. For the latter we already know that this year the ceiling will be breached by more than two percentage points. It is urgent to stipulate an agreement with the prescribers that allows this growth to be governed, otherwise the system will collapse».
A pact of what kind?
«AIFA recently published a benchmarking document on the prescription of generics. In Tuscany we will approve very shortly (perhaps today for the reader, ed) a resolution which implements those prescriptive thresholds on drugs for hypertension and invites doctors to move towards off patents, also thanks to the support of various scientific societies of medicine. No imperatives or sanctions: we only wish for conscious and responsible choices, in the common interest that the system cares and continues to provide high-level assistance".
DoctorNews – September 7, 2010
