Would you get your money back from Barilla or Fiat, just to give two examples, because you spent more than expected on food or on the car? Well, if we are sick and we have to take more drugs than the State has planned, industries, distributors and pharmacists must, by law, give the proceeds back to the NHS. The Finance reconfirms it. If public pharmaceuticals exceed 14 per cent of total NHS expenditure, the excess must be returned by the industries directly (pay-back) and through compulsory discounts from wholesalers and pharmacists. The Medicines Agency, the (very effective) executive body of these government measures, assigns each industry a sales budget calculated on the previous year's turnover, albeit with some technical corrections. Beyond that 14 percent, each company will give back, proportionally, what it has sold more than the budget assigned to it. There's no point in trying to sell more. Grotesque in every other sector: can you imagine Marchionne who in September, given his brilliant accounts, calls his managers and urges them to sell less Punto or 500 because otherwise they will have to give back the proceeds? From a doctrinal point of view, this rule of "payback" smacks of heresy. The entire responsibility for consumption is placed on supply alone, determined instead by the conjunction between supply and demand. With the further aggravating circumstance that the traditional entity of mediation between the two quantities, the price, for category A drugs is defined by the State (on average the lowest in Europe) and not by the manufacturer, thus doubly penalised. Not a market economy, therefore, but a planning economy. But even in this somewhat Politbjuro logic (probably similar to the political-ideological background of Health Minister Livia Turco) a correct planning of expenditure must include all the items competing for the entire diagnostic-therapeutic path for a given pathology. Not only drugs, 14 percent, but also the remaining 86 percent. A "unique" with the patient at the center of the "disease management" of the specific pathology. Today it is utopia. And, seeing the trend, in the words of Sciascia, we fear it is a story that will still have to pass a lot of time before someone will be able to write. fabrizio.gianfrate@unife.it Free Market of 11/12/2007, article by FABRIZIO GIANFRATE p. 5
