Italy rushes much-feared austerity plan to appease markets
This article was originally published in Scrip
Italy has passed into law an austerity plan that had been criticised by the medical technology industry and other healthcare observers for the severity of its impact on the health system.
The approved decree offers some relief, however, for the pharma industry. Subject to its formal publication in the official gazette in the coming days, the approved decree will impose immediately a €10 copayment on “specialised care appointments” and on pathology services, ie clinical analysis or diagnostic testing or screening. For medicines, however, a prescription copayment of €10 is to be introduced from 2014.
The plan was approved last Thursday (14 July) and Friday (15 July) by the upper and lower houses of the Italian parliament, respectively, in a bid to pre-empt any further unease among the international monetary markets. The rushed approval put paid to the further parliamentary debate, which had been expected to continue until the end of the month.
The package, called "manovra", seeks to cut public spending by €79 billion ($111 billion) per year with the aim of reaching zero deficit in 2014. For the national health service, it translates into cost-cutting and copayment regimes that prompted the biomedical technologies association Assobiomedica to warn that the increasing pressure on the supplies industry risked "paralysing" the national health system as a whole (www.clinica.co.uk, 13 July 2011).
In an acknowledgment of the severity of the plan’s impact on the health services, the manovra was described as “hard but necessary” by health minister Ferruccio Fazio. “The government has, however, maintained its policy of guaranteeing access to health services”, he added, alluding to the introduction of exemptions to the copayment regime. These relate mainly to the care of children and the aged.
The Italian regions have flexibility to implement or reject the copayment regime. Seven are introducing it today, two have said no, and five are undecided, Scrip understands.
In addition, Professor Fazio has stated that he is proposing amendments to the copayment regime, "to ensure it is better aligned with the principles of appropriateness [in the use of medicines and technology]".