With the liberalisations, the number of affiliated pharmacies is about to expand, but the pie represented by category A expenditure risks becoming smaller. In fact, it is now almost certain that the Regions will drop from 13.3 to 12.1% the ceiling of territorial pharmaceutical spending this year. It was the hypothesis put forward for 2013 by the July Maneuver of the Berlusconi government, as an alternative to the 35% coverage of the deficit on hospital expenditure by industry, but the estimates on 2012 expenditure and the data for the last two years are convincing regional governments to bring the provision forward by twelve months. Of course at the moment these are just rumors, but the pessimism that can be smelled both in Federfarma and in the acronyms of intermediate distributors makes it clear that we are not mere gossip: officially, the topic is not yet on the agenda of the next governors' conferences, but it is certainly in the box marked "under evaluation". So much so that some assessments are already being made informally in the owners' union on the bill that pharmacies risk paying. Because a 1.2 percentage point lowering of the ceiling would immediately put approved pharmaceutical spending on red alert (red in the sense of deficit, obviously). From which two cascading effects: heavier direct distribution in those Regions that use the dual channel to move slices of expenditure and, next year, the shelf of the breakthrough (almost certain) to be paid by the affiliated pharmacies for a proportion proportional to their margin . This is in the possible and probable future. In the meantime, however, the local pharmacies already have to deal with another payback: it is the one relating to the 2010 expenditure on direct distribution, which the Regions insist on charging not only to industry, but also to wholesalers and principals. For the latter two players, the "bill" would amount to six million euros, to be recovered with an increase in the NHS discount of six tenths of a point. And in the meantime we are awaiting data on 2011 spending, from which a new deficit could emerge.
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