Pharmaceutical expenditure: Aspects of cost containment in Italy

Italy has had a national health service since 1978, to provide access to care to all citizens. The service uses 3-year plans to aim to meet demands and needs. The pharmaceutical sector is well developed with regard to R & D and production. Drug prices are fixed based on comparison prices in other European countries. Position within 3 classes of drugs determines the level of patient co-payment. Genetics have been recognized and included since 1996. Numerous recent events are likely to change the pharmaceutical sector, since recent regulations have not succeeded in reducing prices or utilization.