An evaluation of pharmaceutical co-payment reforms in Spain

Abstract

The sudden fall of public revenues after the long-lasting economic crisis that began in 2008 has led many public health systems in European countries to cut public health financing through high copayments or coinsurance rates on drug prescriptions dispensed in pharmacies. This is especially the case in Spain, where until July 2012 nearly three out of four prescriptions were dispensed free of charge, Spain being until then one of the European countries with a relatively high number of prescriptions per capita1. Spanish health authorities have long sought to control publicsector pharmaceutical expenditure, but the economic crisis exacerbated this, and severe pressures were exerted on the public sector. After more than three decades of medicines being offered free to the elderly, this led in mid 2012 to a new co-payment policy being adopted.