 Spectrum --
August 2008
 Introduction:
In recent years, Spain has rapidly increased its spending on
healthcare, and pharmaceuticals account for a larger share of healthcare
expenditures in Spain than in most other European countries. However, Spanish
drug prices are among the lowest in Europe and have been eroded by repeated
mandatory price cuts. In addition, the government’s strategy of promoting
generics, imposing reference prices on off-patent drugs, and limiting price
premiums to the most innovative drugs will present significant challenges to
the pharmaceutical industry.
Get the Answers You Need to Shape Your Strategy:
 As a result of its generally low pharmaceutical prices, Spain
is a major source of parallel exports to other European countries. How has
the Spanish government responded to this trade? What measures have drug
manufacturers taken to combat parallel exports?
Spanish drug prices are among the lowest in Europe. How
do prices in Spain compare with U.S. and European average prices? Which
drugs are more expensive in Spain than in the United States?
Reference pricing has become the mainstay of the Spanish
government’s pharmaceutical cost-containment strategy. How extensive is the
Spanish reference pricing system? What changes has the government introduced in
recent months? How do pharmacists and physicians view reference pricing? How
can manufacturers delay this cost control?
The government is dissatisfied with the persistent
underdevelopment of the Spanish generics market. What measures have been
introduced to stimulate greater use of generics? How do physicians,
pharmacists, and patients regard generic drugs?
Health technology assessment (HTA) is not well established in
Spain. What steps have some autonomous communities taken to promote HTA? How
will HTA play an important role in the future pricing and reimbursement of new
medicines in Spain?
Scope:
Organization and funding of the healthcare system:
spending on healthcare as a percentage of gross domestic product (GDP);
pharmaceuticals’ share of healthcare expenditures; relative importance of
public and private health insurance; decentralization of responsibility for
healthcare.
Drug prices in Spain: comparison of launch prices in
Spain and other European markets; detailed analysis of Spanish prices of 155
leading biologics and small-molecule as a percentage of U.S. and average
European prices.
Price setting and reimbursement: procedure for setting
drug prices; reimbursement decision-making process.
Cost-containment measures: negative lists; reference
pricing; price cuts; sales tax; prescribing controls; patient copayments; prior
authorization; measures to promote greater use of generics.
Hospital reimbursement: pricing; cost-containment;
hospital formularies.
Health technology assessment: regional initiatives; new
national committee to assess the therapeutic utility and cost-effectiveness of
new drugs as the basis for pricing and reimbursement decisions for new drugs.
Outlook for the Spanish pharmaceutical market:
differences in sales growth rates according to drug price; recent slowdown in
pharmaceutical expenditures; increasing emphasis on pharmaceutical innovation;
decentralization of healthcare policy.
National Pricing and Reimbursement Series: This
report is part of the National Pricing and Reimbursement Series:
Around the world, the market success of branded drugs is influenced by changes
in healthcare systems and the growing role of cost-conscious payers. The National
Pricing and Reimbursement Series analyzes the evolving pricing and
reimbursement environment in seven major markets (the United States, France,
Germany, Italy, Spain, the United Kingdom, and Japan) and assesses the impact
of key changes on pharmaceutical and biotechnology companies.
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