Pharmaceutical expenditure net of the NHS, in first half of 2010, recorded a decrease of -1.4% compared to the same period of 2009, against an increase in the number of prescriptions of +2.8%.
In the first half of 2010 there were almost 299 million prescriptions, equal to 5 prescriptions for each citizen. Almost 547 million packages of medicines were dispensed by the NHS, with an increase of +3.4% compared to the same period in 2009. Every Italian citizen collected an average of 9.2 packages of medicines by the NHS from the pharmacy.
In the month of April In 2010, the net pharmaceutical expenditure under the NHS contract decreased by -2.5% compared to April 2009, while the number of prescriptions increased (+2.6%); in the month of May expenditure remained unchanged compared to May 2009, while the number of prescriptions increased by +5.1%; in the month of June spending decreased by -2.5% against an increase in the number of recipes of +4.3%.
The expenditure trend in the first six months of 2010 continues to be influenced by the increase in the number of prescriptions and the simultaneous drop in the average value of the prescriptions themselves (-4.1%): more medicines are prescribed, but at a lower average price.
This result is due to the reductions in the prices of medicines launched several times by the Government and AIFA (most recently that of the 12.5% on equivalent medicines SSN, in force from 1 June to 31 December 2010), the growing impact of the reference price for equivalent medicines, following the progressive expiry of important patents and the measures applied at the regional level. Among the latter, the extension in various Regions of the reference reimbursement for proton pump inhibitors (measures which, as required by law no. 222/2007, can no longer be introduced); the reintroduction (Abruzzo, Campania, Lazio and, from 8 May 2009, Calabria) or the heavier (Sicily) of the ticket; the direct distribution or through pharmacies of medicines purchased by the local health authorities.
THE CONTRIBUTION OF PHARMACIES TO COST CONTAINMENT
Pharmacies continue to make a significant contribution to cost containment, not only with the diffusion of equivalents and with the timely supply of analytical data on medicines dispensed under the NHS, but also with the discount to the NHS. In the first six months of 2010, pharmacies guaranteed savings of over 310 million euros, precisely with the discount to the NHS, to which must be added over 36 million euros deriving from the pay-back, charged to pharmacies from 1 March 2007, extended for the whole of 2010.
To these charges was added, in 2009, the temporary additional contribution for the year 2009 in the amount of 1.4% of the gross NHS approved pharmaceutical expenditure, established by decree-law no. 39/2009, converted into law no. 77/2009, for a total amount of approximately 180 million euros, totally borne by the pharmacies alone.
The Legislative Decree n. 78/2010 in force since 31 May 2010 also introduced a withholding of 3.65% to be paid by pharmacies, then canceled by the application of a withholding of 1.82%, starting from 31 July and pending the definition of a new remuneration for pharmacies.
It should be remembered that the discount paid by pharmacies is progressive in that it increases as the price of the drug increases, causing the real margins of the pharmacy to be regressive with respect to the price.
&
