Between recipe tickets, private purchases (out of pocket) and sharing on the equivalents (to cover the difference between the reimbursement quota and the price of the dispensed product) the expenditure incurred by Italians in the first four months of 2017 for category A drugs amounts to approximately one billion euros. And half of this expenditure is concentrated in four regions only, 
Lombardy, Campania, Lazio and Sicily, where moreover 44% of the population resides. This is another evidence that emerges from the report with which QuintilesIms photographed the dynamics of this first part of the year.
As already the agreed pharmaceutical expense, which in the first four months turns out to be almost stable compared to the same period of the previous year (-0.5%), private spending by Italians also shows almost intangible changes over the year (-0.4%). Of the 1,068 million euros paid by families for class A drugs, then, about half (528 million) come from private purchases, 166 from co-payments on prescriptions and 378 from the reimbursement portion on equivalents.
The Lombards are, by far, those who spend the most for all three items (91 million in private consumption, 46 in tickets, 50 in sharing of equivalents), the inhabitants of the regions that immediately follow in the general ranking do not they always place on the same step in the detailed rankings: the people from Campania, for example, are confirmed in second place for consumption and tickets (66 and 26 million respectively) but fall to third on the equivalent (42 million) because they are overtaken by the Lazio (48). Which, in turn, are overtaken by the Sicilians in spending on recipe tickets (17 million against 10 for the former). Finally, the expenditure incurred by the Apulians for sharing on the "without patent" is also very respectable: 30 million euros in four months, which from ninth place in the general classification make it rise to fifth in the detailed ranking. It remains to be understood whether this makes the residents of the heel of Italy happy.
