The Italian Medicines Agency (Aifa) published the «Monitoring of national and regional pharmaceutical expenditure» referring to the period January-September 2022. Pharmaceutical expenditure, calculated at 
net of the discounts, the total co-participation and the pay-back paid to the Regions by the pharmaceutical companies, it is 5,720.4 million euros.
This highlights a slight increase, compared to the previous year, of +77.2 million euro. The number of prescriptions disbursed (419.3 million) showed the same trend with respect to this increase, showing a change of +2.3% on 2021. The incidence of the ticket, i.e. the "out of pocket" expense of patients, increased by +1.7%. As for drug consumption, the number of daily doses shows an increase of +0.5%, equal to 87.8 million dispensed.
With reference to the regional approved pharmaceutical expenditure incurred through the payment of the summary accounting slip to private and public territorial pharmacies, the Aifa report shows that the Regions with the greatest percentage increase are Lombardy (+4.6%), PA Trento (+4 ,2%) and Molise (+3,8%).
The regions with a decrease are Umbria (-4.0%), Sicily and Campania (-1.1%). In most of the Regions there is an increasing trend of the concessions, with a recovery compared to the negative trend highlighted in the previous year. Other regions with a positive gap include Abruzzo (+3.0%) and Emilia-Romagna (+2.6%).
The monitoring of pharmaceutical expenditure that AIFA periodically publishes is an essential prerequisite for the planning of pharmaceutical assistance in Italy.
AIFA carries out monthly monitoring of pharmaceutical expenditure data and communicates the related results to the Ministry of Health and the Ministry of Economy and Finance with the same frequency. On May 31st, October 30th and December 31st of each year, the Agency verifies whether the expenditure ceilings have been exceeded at national level, both for pharmaceutical expenditure under the agreement (7.96% of the national health requirement) and for direct purchases (6.69% + 0.2% of national health needs).
The monitoring of pharmaceutical expenditure is conducted on the basis of the agreed expenditure data and the Summary Accounting Lists (DCR) acquired by the Regions, as well as the data acquired by the New National Information System (SIS) of the Ministry of Health, relating to the traceability of the drug (DM July 15, 2004).
With effect from 1 January 2017, in the estimates of the Ministry of Health, a Fund was established for the reimbursement competition for the Regions for the purchase of innovative non-oncological medicines, with a budget of 500 million euros per year and a Fund for the reimbursement competition for the Regions for the purchase of innovative oncological medicines, with a budget of 500 million euros per year.
