RIMINI – The round table entitled 'Healthcare for all: a system with an expiration date?' was held during the Rimini meeting, with the aim of discussing the sustainability of the National Health System.
The meeting, which saw the participation of Giorgio Bordin (president of Medicine and Person), Raffaele Donini (coordinator of the Health commission of the Conference of the Regions), Fabio Pammolli (full professor of economics and management at the Polytechnic of Milan) and Riccardo Zagaria (CEO of DOC Generici), outlined the characteristics that the health system should have: sustainable, friendly, subsidiary, supportive and above all that places the patient at its center, whoever he or she may be.
The Minister of Health, Orazio Schillaci, also wanted to participate in the round table, sending a letter commenting on the topics discussed.
THE ITALIAN POPULATION'S RACE TOWARDS AGEING
The Italian population is aging ever faster: according to Istat data for 2021, almost one in four people (23,5%) is aged 65 or over, and this figure is expected to rise to 34,9% in 2050. This phenomenon is due to the lower birth rate and higher life expectancy, which in 2070 could reach 86,5 years for men and 89,5 for women.
This demographic change brings to light new needs not only for social support, but also for health policies that can meet the needs of this growing segment of the population.
The aspect that most determines the health needs of the elderly is represented by the persistent accumulation of chronic pathologies: over half of the population over sixty at a global level has more than one chronic condition (multimorbidity) and the prevalence of polypharmacy, or the chronic use of at least 5 drugs per day, is also growing.
For this reason too, the NHS needs adequate funding, to be able to count on trained and adequately motivated professionals, capable of guaranteeing everyone access to care and therapies according to the times defined by need, emergency, acuteness and chronicity.
A health service that pursues without hesitation the right to health of its citizens.
“One of the fundamental elements for the sustainability of the healthcare system – states the CEO of DOC Generici, Riccardo Zagaria – concerns the economic aspect: the aging of the population and the consequent increase in the use of drugs impacts both the pockets of citizens and the healthcare system”.
“DOC has always been at the forefront of training - he continues - with the aim of increasing the culture of sustainable health also economically, through the use of generic drugs, which due to their lower cost promotes greater adherence to the prescribed pharmacological therapy”.
DATA FROM THE OSMED REPORT
In this regard, the latest data from the OSMED report just published show that in Italy in 2022 more than 6 out of 10 citizens received at least one prescription for drugs. An increase in per capita spending and consumption was observed with increasing age.
In particular, the population over 64 years of age absorbed over 60% of the expenditure and doses. In the elderly population, the average expenditure per user was 556 euros (601,5 in men and 520,8 in women). Almost the entire population (98,4%) received at least one drug prescription during the year.
EQUIVALENT DRUGS
Among the aspects that could help achieve these goals is the use of equivalent drugs. According to the Italian Medicines Agency, an equivalent drug is defined as “a medicine that, in addition to containing the same quantity of active ingredient in its formulation, also has bioequivalence, demonstrated by appropriate bioavailability studies, with another reference medicine (better known as a “branded” or “designer” medicine) with an expired patent”.
Italy is third to last in comparison with Austria, Belgium, Germany, Great Britain, France, Poland, Portugal, Sweden and Spain, both in terms of expenditure and consumption of generic drugs.
In particular, the incidence of expenditure for equivalents stands at 43,4% compared to an average percentage of territorial expenditure for equivalent drugs in the countries analyzed of 47,6% (EU average: 48,3%) and varies between 34,7% in Belgium and 68,6% in Poland. The percentage of consumption instead varies between 50,6% in Belgium and 81,8% in Great Britain, and stands at 54,9% in Italy.
“The reflection we need to make, in light of the growing total pharmaceutical expenditure - continues Riccardo Zagaria - is how to ensure that the drug, increasingly indispensable in our society, can continue to be available and accessible in the coming years in a homogeneous way”.
“It is essential in this sense,” he underlines, “to guarantee the sustainability of the drug production system, to increase pharmaceutical spending by adjusting the spending limit for direct purchases, and to completely review the flows of direct and on-account distribution, aiming for uniformity at a national level.”
MINISTER SCHILLACI'S LETTER
"A health service that is, and remains, strongly anchored to the principles of universality, equity and equality - we read in the letter sent by the Minister of Health, Orazio Schillaci - needs a strong restorative cure, postponed for too long. The goal is to make our NHS more attractive, acting on two levers: the economic one, with better salaries for health workers and the organizational one, reviewing a model that does not work as it should".
“One of the key factors for the healthcare of the future – the text continues – is digitalization. I am thinking of telemedicine, on which we are in an advanced stage, which plays an essential role in strengthening local healthcare or the Electronic Health Record which has finally entered its operational phase”.
“We are working together with regions, associations and social partners - concludes Schillaci - for a medium-long term healthcare, rethinking a public medicine that is closer to people and more innovative".
EDITORIAL TEAM
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