Health will not have all the funds it needs to meet the challenges of the decade. The 2021-2024 Stability Program eliminates one of the Executive’s commitments, reaching public spending for Health equivalent to 7% of GDP at the end of the legislature. Moreover, that percentage will not be reached until the middle of the century, according to the document itself.
In 2024, according to the document sent to Brussels, health spending will be 6.2% of GDP, practically equivalent to the same as it was before the arrival of the coronavirus (6.1%). In euros, and taking the year 2022 as a reference (which is when it is expected to be at 2019 levels), 0.8% less GDP translates into just over 11,000 million that will not be available for Health.
This decision will result in a tight budget for all the reforms and projects that must be undertaken, especially when one of the priorities is to improve primary care and the working conditions of doctors and nurses. One of them is to attract the manufacturing currently taking place in Asia of essential drugs. The industry claims that the prices of these drugs (already mature and with little economic impact) have special consideration. The main reason, beyond the profit margin to be achieved, is that production costs differ greatly in Spain compared to India or China.
These drugs are subject to a system called the Reference Price System. It is a tool that annually depreciates the value of medicines, especially with the appearance of a generic or after a decade of solo marketing. One of the formulas that has been considered was that these drugs should have special consideration. In addition, one of the offers of the industry was to value incremental innovation. That is, paying more for a historical drug to which an improvement is added so that its use is more efficient for the patient.
Along with the tight budget for Health, there are the priorities of the Ministry directed by Carolina Darias. It is true that the pharmaceutical project is more linked to the Ministry of Industry, but it needs the support of health policies. In the 1,069 million euros of European funds that will be allocated to Health (of the 70,000 received, something that also shows a loss of interest in reforms in this sector), the impulses to pharmaceutical policy are related to the containment of spending .
control spending
On Tuesday night, Minister Carolina Darias explained the priorities of her portfolio with European funds. “Regarding the regulation of medicines, the Consolidated Text of the Law on guarantees and rational use of medicines will be modified, with the aim of adapting it to the current and future needs and challenges in terms of pharmaceutical policy of the SNS, to new disruptive scientific advances, delve into measures to rationalize pharmaceutical spending, and encourage the rational use of medicines,” he said.
In addition, Health adds that “the fifth block of investments will be allocated to the plan for rationalizing the consumption of pharmaceutical products and promoting sustainability. Thus, improvements will be made in the evaluation systems for medicines, technologies and health benefits and will promote the use of generic and biosimilar medicines in the SNS”.
These words express the will to recover a document that had been buried by the pandemic: the Plan for the Promotion of Generics and Biosimilars. It is a strategy that raised blisters in its day and that the Ministry of Health wants to take to the Interterritorial Council when the coronavirus is left behind. Of course, between the communication on Tuesday from the Ministry and the Resilience Plan presented by Moncloa there is a variation that is not minor: the latter does include the promotion of innovative medicines. This circumstance, together with the fact that this document also refers to the development of the Strategic Plan for the Pharmaceutical Industry, maintains calm, according to sources in the sector.
On the other hand, what is expected to be allocated European funds (792 million) is to improve the technological park of hospitals. Health assumes the obsolescence of a large part of the diagnostic equipment and wants to reform them. For this plan, more tangible movements have been seen. The Fenin employers estimated just before the pandemic broke out that 1,600 million were needed spread over four years to end the problem and in the 2021 budgets there are 400 million collected.
Astrazeneca, next week
The Interterritorial Council reported yesterday on the news reached within the Public Health Commission regarding vaccines. As reported by this medium, the Janssen antigen will now be used with people over 50 years of age, instead of being restricted to the population range of 70 to 79 years. However, the second dose of the AstraZeneca vaccine for the nearly two million Spaniards under the age of 60 who received it is still in limbo. Health insists on giving time to the clinical trial that mixes a first dose of the British serum with a second prick from Pfizer.
It was for this reason that he initially delayed the second dose of AstraZeneca from 12 to 16 weeks, contravening the technical data sheet of the vaccine. The final decision, as Minister Carolina Darias advanced yesterday, will be taken next week, in order to be able to put the booster dose in the week of May 24, which is when it corresponds.
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