The non payment, the fall of the margin and the increase in the workload apuntillan system health and pharmaceutical

presentation of the study risks of the welfare State in drug delivery and proposals for an efficient model ”

-the measures referred to in the study would generate an economic positive impact of 4,000 million euros.

-offices of pharmacy with a volume of annual turnover to the national health system of between 15,000 and 20,000 recipes are at risk of survival.

-Performed in offices of pharmacy dispensing of medicines in hospitals facilitates the control of expenditure and prevents current covert copayment associated with dispensing in hospitals. In addition, favors the creation of employment.

Madrid, October 2011.- The growing incidence of chronic diseases by increased life expectancy, the lack of control in spending on hospital medicines and a problem of moral hazard in the consumption of drugs are the determinants of the growth of spending on medicines in Spain, according to the study risk of the welfare State in drug delivery and proposals for an efficient model submitted yesterday in Madrid.

Responsible for study, Dr. Francesco D. Sandulli, Professor at the University Complutense of Madrid and of California, Berkeley, and Professor David Cordova, director of senior programs at IE Business School, introduced him with the President of the Business Federation of pharmacists Spaniards (FEFE) Fernando Redondo. At the start of the event, Redondo referred to the non-payment, the big problem that threatens health in general and the pharmacist in particular, and noted the fall in the margin, the increase in the burden of work and, above all, default, apuntillan ” sector.

Analysis of situation

Professor Sandulli began the presentation of the study explaining that the increase in the incidence of chronic diseases – the first of the causes of the growth of spending – implies increased demand for medicines per capita and increases the weight of the passive classes in total consumption of drugs. As for the lack of control of the cost of medicines in hospitals, said that it has doubled in the last decade and the bulk of this expenditure is caused by patient, causing, in addition, a covert co-pay ”. Complutense University Professor also spoke of the problem of moral hazard in the consumption of drugs ” because the current system of co-responsibility in the payment of medicines the patient is becoming uncoupled from the economic impact of their consumption.

Professor Sandulli later addressed the economic viability of the pharmacy Office stating that between 1999 and 2009 spending on medicines excused in pharmacy Office grew 3.7 percent, while in 2010 the same expenditure fell by 7 per cent ”. In addition, in the last decade, the number of prescriptions per capita has increased 40%, while spending for prescription has fallen 32 percent. A fall in turnover and margin per employee, also occurs that increases the workload per employee. Thus, if the threshold of profitability was 14,500 recipes, by end of 2011 will be it placed on 17,500 recipes.

Containment

The first measurement of containment is to promote the monitoring of the State of health of citizens through specialised offices of pharmacy pharmaceutical intervention. The study reflects that if 30 percent of the population of chronic patients receive a specialized pharmaceutical intervention service the positive economic impact would be 1.6 billion euros. In addition, it would create skilled jobs.

On the other hand, if 30 percent of the drugs given in hospital gave at offices of pharmacy, the positive economic impact would amount to 590 million euros. Professor Sandulli qualifies in this respect that though it erodes the margin of the Office of pharmacy, helps the patient ”.

The third measure put forward in this study seeks to quantify the problem of moral hazard and is to redefine the system of financing and co-responsibility for consumption of drugs. Experts study here a simulation. Thus, they were considering elasticity of the demand for drugs equal to – 0.1, the measure might encourage responsible consumption and a reduction in spending of about EUR 360 million. The net effect on the Spanish economy would be good, to save 550 million euros.

The last proposed measure is also aimed to alleviate the effects of the problem of moral hazard and to achieve maximum economic efficiency in the access to medicines. It aims to reduce public spending in pharmaceutical on a set of drugs for the treatment of mild and occasional pathologies. As well, to make an approach to the defects of this measure and be able to quantify, was raised a theoretical exercise about all the medications of less than 2 euros PVL. This measure, which does not penalize patients with economic resources more small – medium of the same no more than 0.2 per cent of the pension being the impact more low – would produce an economic positive impact of over 738 million pesetas.

The study concludes talking about measures of increased productivity of Office Pharmacy and points out that if the ability of each employee productivity increased by 17 percent, the economic impact of the measure would be earnings exceeding the EUR 80 million, but employment would be destroyed and would not favour smaller pharmacies.

The conclusions.

-the consumption of drugs has better performance than other items of expenditure health.

-the three main causes of the growth of spending on medicines in Spain are:
1. Increasing incidence of chronic diseases and life expectancy
2. Lack of control in the cost of medicines in hospitals.
3. Problem of moral hazard in the consumption of drugs.

– the Office of pharmacy is trapped between two opposing forces: the fall of the margin and the increase in the burden of work.

-the economic viability of the offices of pharmacy with an annual turnover to the national health system located between 15,000 and 20,000 recipes are at risk for survival.

-specialized pharmaceutical intervention It helps to contain hospital expenses generated by the growing population of chronically ill and allows the creation of employment.

-the dispensation of medicines at the pharmacy instead of in the hospital Office facilitates the control of expenditure on medicines and prevents current covert copayment associated with hospital delivery and allows the creation of employment qualified.

-the responsibility of the citizen in the spending and the Elimination of the coverage of medicinal products used in minor pathologies allows the promotion of the responsible consumption of drugs and the moderation of the fall in the margin trade.

-productivity improvement action facilitates the absorption of the growing workload in the Office of Pharmacy, but does not imply any advantage for small pharmacies.