Press review

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Italy faces €2.6 billion deficit in hospital/direct drugs budget by 2021 unless reimbursement funding restructured - analysts

MILAN, 1 Nov (APM) - Italy will need to restructure its reimbursement funding if it wants to avoid a huge imbalance between its two budgets, analysts from a Milan business school said in an article published in Tuesday's Il Sole 24 Ore.
Overspending of the budget for drugs purchased directly from healthcare companies, including all those used in hospitals, is forecast to increase from €2.24 billion in 2018 to €2.62 billion in 2021.
Expenditure of the budget to pay for reimbursed drugs distributed through the contracted pharmacy network is going in completely the opposite direction. A surplus is expected to rise from €803 million in 2018 to almost €1.7 billion in 2021.
The authors, who are all part of the health economics division Cergas at Bocconi business school, identified the problem as being underfunding. One budget has spending which is increasing very rapidly but the rules do not allow resources from the other budget to be used to compensate for its huge deficits.
The Cergas team forecast that payback from companies to cover half of the overspending of the hospital/direct budget will become increasingly burdensome, unless the scheme is reformed.
They said the reimbursement budgets system needs to be reviewed and restructured so they are more consistent with the absolute values and the expected trends in their respective spending.
The authors' annual drugs spending report, 'Report Annuale dell'Osservatorio Farmaci', was published this week. It showed that payback from pharma amounted to about 7% of total drugs spending between 2013-2018 and 12.5% of expenditure on drugs bought by local health enterprises over the same period.
The report noted that reimbursement spending is increasingly accounted for by purchases of products to be used in hospitals or distributed directly to patients.

India aims to be top five pharma producing nation by 2030

India is aiming to become a top five pharma producing nation by 2030 despite impurities' scandals which have led to products being withdrawn all over the world, Fortune Italia said on Wednesday.
The Indian Pharmaceutical Alliance (IPA) has drafted an action plan for a big increase in manufacturing. India is already the third largest producer of drugs in terms of volume but only 11th for sales which are currently around $38 billion a year.
Current growth rates point to the country having $80-$90 billion sales by 2030. But IPA's plan is aimed at doubling India's share of the global market to take it from 3.6% to 7%. That would mean having between $120-$130 billion sales by 2030.

25 patients groups want automatic biosimilar substitution proposal dropped

Some 25 patients groups have signed an open letter to call for a proposal from medicines agency AIFA to allow automatic substitution of biologicals with their reference biosimilars to be dropped, About Pharma reported on Monday.
The associations have asked the health minister to ensure such a measure is not included in the 2020 budget law which is being put together by the government.
The associations, which include oncology, respiratory and dermatology groups, insisted they are not against biosimilars as long as their use is decided by a doctor. They accept switching patients to biosimilars should be possible but insist this should always be a doctor's decision and never automatic.
"We cannot accept reasoning which means savings are made at the expense of access to treatments for chronic patients with serious conditions, given that they are only provided with biological drugs after all other therapeutic options have failed," the associations said.

Direct-acting antivirals to treat hepatitis C lose innovative status in 2020

The head of a patient group has warned parliament that direct-acting antivirals used to treat hepatitis C infection will start to lose their innovative status in 2020, undermining the plan to eradicate the disease, Quotidiano Sanità reported on Thursday.
Ivan Gardini, who is president of EpaC Onlus, addressed a hearing of the social affairs committee in the chamber of deputies this week. It is part of a parliamentary enquiry into the prevention and elimination of hepatitis C in Italy.
Gardini described the drugs as "real life savers" because they are almost 100% effective. But he noted that innovative status is granted for two years only and the first direct-acting antivirals to be approved in Italy will have completed the mandatory period early next year and lose access to special funding.
Gardini told the hearing that such an important programme as the eradication of a disease should not be limited or compromised by "bureaucratic deadlines".
The patient group chief emphasised that there are still many people infected with hepatitis C who have not been diagnosed. He said an effective screening programme needs to be implemented and funding for direct-acting antivirals to be continued so that new patients can be treated.
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