Copayment drives down public spending on prescription drugs

Government spending on medicines fell an annual 24 percent in July after a copayment system came into operation for the first time, according to figures released Monday by the Health Ministry.

Among other aspects, under copayment, seniors now have to pay part of the treatment they receive, whereas previously the cost came from the coffers of the National Health System (SNS). The fall in July was the biggest in any month since 1999, when the authorities first began keeping a register of what was spent on medicines.

The transfer of part of the cost of SNS treatment to individuals had been flagged by the inflation figures for July, which showed that the price of prescription drugs had risen 36 percent.

Spending by the SNS in July amounted to 702.8 million euros, down from 923.9 million in the same month a year earlier. The number of prescriptions handed out fell 14.1 percent to 67.4 million, the biggest fall on record. Average spending per prescription was down an annual 11.4 percent

The last time the price of medicines - as captured by the consumer price index - rose significantly was in the 1980s. The introduction of the copayment system was also behind the rise in the headline inflation rate from 1.9 percent in June to 2.2 percent in July, the highest rate for the year so far.

Basque Country alone

The region that saw the biggest fall in spending by the SNS in July was Murcia, where it declined 35.0 percent. Murcia was followed by Castilla y León with a decline of 32.9 percent, Castilla-La Mancha with a fall of 30.9 percent and Madrid, where outlays were down 30.5 percent.

The statement released by the Health Ministry showed the only region where SNS spending on medicines increased was the Basque Country, whose Socialist-led government has refused to introduce the copayment system. Spending in the northern region rose 2.8 percent to 44.8 million euros.

However, the department of health of the Basque County accused the Health Ministry of manipulating the figures in order to undermine the image of the regional government.

The Basque government put the spending figure at 41.3 million euros, down from 43.6 million a year earlier.

The regions have responsibility for health and education in Spain but the copayment system was introduced by the conservative Popular Party government of Prime Minister Mariano Rajoy as part of a battery of austerity measures to rein in the public deficit. Spending cuts on education and health worth some 15 billion euros were imposed on the regions.

In Andalusia - which is also in the hands of the Socialist Party and has appealed the introduction of copayment - spending on medicines declined 16.5 percent.

The austerity drive has also impacted the pockets of pharmaceutical companies. A spokesman for the industry association Farmaindustria estimated that since the government initiated belt-tightening in 2010, turnover in the sector had fallen by between three and five billion euros.

However, he said the association considered the spending cuts a "lesser sin" if they succeeded in guaranteeing SNS spending on medicines was sustainable over the longer term.