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Incentives and pharmaceutical reimbursement reforms in Spain



The aim of this paper is to assess whether cost-containment has been affected by recent pharmaceutical reimbursement reforms that have been introduced in the Spanish health care system over the period 1996-2002, under the conservative Popular Party government. Four main reimbursement policies can be observed in the Spanish pharmaceutical market after 1996, each of them largely unintegrated with the other three. First, a second supplementary negative list of excluded pharmaceutical products was introduced in 1998. Second, a reference pricing system was introduced in December 2000, with annual updating and enlargement. Third, the pharmacies’ payment system has moved from the traditional set margin on the consumer price to a margin that varies according to the consumer price of the product, the generic status of the product, and the volume of sales by pharmacies. And fourth, general agreements between the government and the industry have been reached with cost containment objectives. In the final section of this paper we present an overall assessment of the impact of these pharmaceutical reimbursement policies on the behaviour of the agents in the pharmaceutical market.

Suggested Citation

  • Jaume Puig, 2003. "Incentives and pharmaceutical reimbursement reforms in Spain," Working Papers, Research Center on Health and Economics 679, Department of Economics and Business, Universitat Pompeu Fabra.
  • Handle: RePEc:upf:upfses:679

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    References listed on IDEAS

    1. Rodriguez, Marisol & Scheffler, Richard M. & Agnew, Jonathan D., 2000. "An update on Spain's health care system: is it time for managed competition?," Health Policy, Elsevier, vol. 51(2), pages 109-131, March.
    2. Lopez-Casasnovas, Guillem & Puig-Junoy, Jaume, 2000. "Review of the literature on reference pricing," Health Policy, Elsevier, vol. 54(2), pages 87-123, November.
    3. Rosa Nonell & Joan-Ramon Borrell, 2001. "Public demand for medicines, price regulation, and government - industry relationships in Spain," Environment and Planning C: Government and Policy, Pion Ltd, London, vol. 19(1), pages 119-134, February.
    4. Nina Pavcnik, 2000. "Do Pharmaceutical Prices Respond to Insurance?," NBER Working Papers 7865, National Bureau of Economic Research, Inc.
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    More about this item


    Spanish health care system; negative list; reference pricing; pharmacy reimbursement; pharmaceutical industry;

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H5 - Public Economics - - National Government Expenditures and Related Policies

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