- June 2020
Spending by Spain’s National Health Service (NHS) on pharmaceuticals was €12.1 billion in 2010. Its market for prescription medicines is among the slowest growing in Europe, expanding by only 1% for the 12 months to September 2010 – half of…
Spending by Spain’s National Health Service (NHS) on pharmaceuticals was €12.1 billion in 2010. Its market for prescription medicines is among the slowest growing in Europe, expanding by only 1% for the 12 months to September 2010 – half of the average of 2% for the five largest European markets.
Spending by Spain’s National Health Service (NHS) on pharmaceuticals was €12.1 billion in 2010. Its market for prescription medicines is among the slowest growing in Europe, expanding by only 1% for the 12 months to September 2010 – half of the average of 2% for the five largest European markets. Reimbursement over the same period grew 2.3%, above Italy’s -1.2%, but well below France at 3.3%, the UK at 4.4% and Germany at 4.6%. For the 12 months preceding September 2010, reference priced generics accounted for 23.5% of the Spanish market by value, and 38.2% by volume. The penetration of generics in Spain, however, is low for Europe – about 12% by volume compared to 65% for the UK, for example. The past decade has been a time of major change in Spain’s medicines market, with key events occurring in 2002, 2004, 2006 and 2010.
In 2010, the reference pricing system again was changed and additional price cuts and rebates requirements were imposed.
The role of Spain’s autonomous regions has been focused on affecting demand. For example, some regions have established agencies to evaluate therapeutic utility as a basis for creating prescribing guidelines. Serious questions have been raised about the quality of the evaluations and the appropriateness of the consequent guidelines, particularly because both financial and non-financial incentives have appeared to encourage physicians to follow the guidelines.
Other demand-side initiatives include, for example, regional reference pricing systems, binding only when prescription is by active ingredient; increasing generic prescribing; regional tendering; and creating regional catalogues that prioritise reimbursed medicines. Some such efforts, the catalogues, for example, appear to exceed regional authority and are being reviewed by the Department of Health.
Not all regions are equally active, of course, and they vary in the measures taken. For example, Andalusia, Catalonia and the Basque Country have taken the lead in pharmacoeconomic evaluations; Andalusia, the Canaries, Castilla-La Mancha, Castilla y Leon and Valencia have imposed regional reference prices; and Navarra, Extremadura, Catalonia and, soon, La Rioja attempt to shape prescribing and encourage greater use of generics.
For more information, please contact Dr. Jorge Mestre-Ferrandiz at OHE.
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