Pharmaceutical expenditure and containment measures in Spain

Abstract

The paper describe the evolution of pharmaceutical spending in Spain in the last decade, especially after the measures taken to reduce it in 2009. Pharmaceutical spending progressively increased between 2003 and 2009, decreasing from 2010 to 2016, to the same level of the beginning of that period, both in terms of total expenditure and per capita. Expenditure for medicines dispensed in community pharmacies suffered a cumulative gross reduction of 23.76% between 2009 and 2013, resulting from the reduction of both the media cost of prescriptions and the number of prescriptions, reversing the trend of the previous period (2003-2009) of progressive increase of the expense by prescription and of the number of these. In recent years, hospital pharmacies passed to cover pharmaceutical care for a variety of outpatients, which has resulted in a large increase in hospital pharmacy spending by transferring medicines from the community pharmacy to the hospital pharmacy. In 2013, Spain had a high proportion of pharmaceutical spending through hospital pharmacies (27% of the total). Consequently, the total pharmaceutical expenditure in Spain has not fallen, as could be deduced from the data indicated in community pharmacy, but amounted to more than fifteen million euros. The paper also presents the most relevant measures implemented by health authorities to reduce the bill for medicines.