The first quarter of 2006 marks a strong increase in pharmaceutical expenditure which increases by + 14.5% in January and + 8% in March with a quarterly average of +10.5% (prescriptions have grown on average by 6%).
The response from AIFA was not long in coming and the Agency's Technical-Scientific Commission (meeting on 4 May) is already studying possible interventions to counteract its growth.
The first concerns the recovery of the spending deficit through a cut in the margins of the pharmaceutical industry, as already happened in 2004.
The second considers a percentage cut on the prices of drugs which have recorded above-average increases.
The third intervention, which if implemented would be the most dramatic, envisages a radical reorganization of the entire Formulary with the establishment of the reference price for homogeneous pharmaceutical categories and differences to be paid by the patient if the prescribed drug has a higher price than the one refund acknowledged.
The inhibitory effect on pharmaceutical expenditure, if this third hypothesis were applied, is evident to all, but the effects that this choice would have on the dynamics of employment levels are even more evident and formidable. For this reason, caution and checks by the Technical-Scientific Commission should be the main objectives to be pursued before implementing this radical choice.
At the regional level, with the dissemination of the first data on the increase in pharmaceutical expenditure, it should be noted that the debate between general practitioners and specialists regarding induced prescriptions has been resumed, especially in Lazio, where some ASLs send warning letters to GPs with threats of possible sanctions in case of exceeding the individual prescriptive limit. Among family doctors there are those who propose that, in order to contrast the phenomenon of prescriptions induced by specialists, it is the general practitioner who decides whether the patient should undergo a specialist visit or not. Otherwise, the prescription induced by a specialist visit not authorized by the doctor must be paid for by the patient. Furthermore, AIFA is working on the revision of the prescriptive notes (which should be ready in a few months) and which will be clearer as regards the references to the therapeutic plans prescribed by the specialist.
It should also be noted that in Molise and in Campania an experimentation called “Progetto Arianna” has been launched to which around 230 doctors adhere who will have to indicate on the prescription, in addition to the prescription, also the pathology. The data provided will then allow to know the drugs prescribed for each pathology and therefore to analyze and identify the prescriptive "golden standard" for each pathology.
