Spain aims to slow the rise in spending on drugs

BMJ 1999; 319 doi: (Published 03 July 1999) Cite this as: BMJ 1999;319:11
  1. Xavier Bosch
  1. Barcelona

    With the slogan “just a drug, plain and simple,” Spain's Ministry of Health has started a nationwide campaign to explain to the public the importance of generic drugs.

    Simultaneously, it has approved a new pricing system to be launched in September, under which pharmacists will substitute a generic drug for a branded product if the branded product exceeds a certain price laid down by the ministry.

    The aim is to contain spending on drugs, which has been rocketing in the past few years. During 1998, prescription drugs accounted for 23% of Spain's public healthcare expenditure (nearly £4.3bn; $7bn), the highest proportion in Europe. In the first four months of this year alone, spending on drugs rose by 13.9.

    The Ministry of Health is hoping that the combined effect of both measures will be to reduce the annual rise in spending on drugs to 9.1% by the end of this year.

    Although the sale of generic drugs has been increasing recently, it accounted for only 1.3% of total drug sales in 1998. Federico Plaza, general director of the pharmacy department of the Ministry of Health, thinks that generic drugs might make up 10% of total drug sales in 2001.

    Generic drugs in Spain are between 10% and 50% cheaper than their brand name equivalents. According to Mr Plaza, “the diffusion of generics mainly depends on the intention and will of doctors to prescribe these drugs instead of their peer brand ones.”

    In fact, he says, doctors from the primary care network “are already receiving incentives to augment the prescription of generic drugs.”

    But the consumption of generic drugs “will notably increase from September, when the system of reference prices will be applied,” he explains.

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