It is a strict marking that the Tuscany Region is exercising on the pharmacies of the area so that they review their no to centralized tenders for the purchase of A-level drugs. Pressures which are increasingly difficult to resist, so much so that the regional Federfarma has already set for Sunday November 13 a meeting of all Tuscan owners. The terms of the dilemma weighing on pharmacies are known: the first notice arrived in December with the 2011 regional budget, which in article 14 proposed for the first time agreements «with the union associations of the affiliated pharmacies» with which to identify «further modalities for the distribution on the territory of drugs and medical devices purchased directly from the Regional Health Service»; then, in March, the first trials of the agreement with family doctors which entrusts the local health authorities with the home delivery of class A drugs for complex chronic patients; finally, in May, the resolution on the safeguard clause for equivalents with prices not aligned with the new Aifa quotas, which in point 4 orders the local health authorities to enhance «the direct distribution of off-patent drugs to clients until a non-patented percentage is reached lower than 15 % of 2010 consumption». Three pieces of a mosaic that essentially aims to extend the mechanisms of the dpc to the entire handbook of reimbursed drugs: the Region would purchase with tenders by homogeneous therapeutic category, off patent and branded together, whoever offers the least wins; pharmacies would dispense in exchange for a fixed portion per piece, as already occurs in distribution on account. "The administration has been pressing for months to reach that agreement proposed by the finance company," explains the president of Federfarma Toscana, Marco Nocentini Mungai [in the picture] «and so far we have managed to prevaricate. Now, however, a position must be taken, also because there are indications that suggest an intensification of home distribution to chronic patients". Hence the convening of the assembly: «I want all the Tuscan owners to be made aware of the terms of the problem» he continues «and that together we decide what to do: I want a clear mandate to open a negotiation or say definitively no. Because we are talking about an agreement that would involve the 70-80% of drugs intended for chronic therapies, the purchase of which would be taken away from the owners and directly taken over by the Region. An eventuality which, among other things, would entail the risk of a financial shock for a couple of hundred pharmacies, because in the initial phase the financial flow which today allows many pharmacists to have 120-day deferred payments would be lacking».
November 3, 2011 
