The growth in expenditure on the financing of pharmaceuticals is a factor that accounts for a large part of the increase in public health spending in most developed countries. In an attempt to kerb this growth, many health authorities, particularly in Europe, have introduced numerous regulatory measures that have affected the market, especially on the supply side. These measures include the system of reference pricing, the reduction of wholesale distributors’ and retailers’ markups and compulsory reductions of ex-factory prices. We assess the impact of these cost containment measures on expenditure per capita, prescriptions per capita and the average price of pharmaceuticals financed by the public sector in Catalonia (Spain), from 1995 to 2006. We apply an autoregressive integrated moving average (ARIMA) time series model using dummy variables to represent the various cost containment measures implemented. Twelve of the 16 interventions analysed that were intended to contain the overall pharmaceutical expenditure were not effective in reducing it even in the short term, and the four that were effective were not so in the long term, thus amounting to a moderate annual saving.
Pharmaceutical expenditure Pharmaceutical policy Cost containment measures Time series
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Financial support is acknowledged from the Servei Català de la Salut and the Spanish Ministry of Education and Science under grant SEJ2007-66133. We also benefited from the support of an unrestricted educational grant from the Merck Company Foundation, the philanthropic arm of Merck & Co. Inc., Whitehouse Station, New Jersey, USA. The authors have no financial or other conflicts of interest that are directly relevant to the content of this article and thank Carles Murillo, Arantxa Catalán, David Magem and two anonymous referees for their helpful comments. We are also grateful to the Servei Català de la Salut for data used in this paper. The opinions expressed are those of the author and do not necessarily reflect the opinions of the research sponsors.
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