Garattini Silvio
Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.
J Ambul Care Manage. 2004 Apr-Jun;27(2):120-6. doi: 10.1097/00004479-200404000-00007.
The advent of the National Health Service in 1978 in Italy also resulted in the compilation of a formulary of pharmaceutical products to be distributed free of charge. During the subsequent years the formulary increased in size with the introduction of new drugs and consequently pharmaceutical expenses increased steadily, reaching a peak in 1992. The years preceding this peak of expenses were characterized by pervasive corruption that involved several government civil servants and even the Minister of Health, as well as several members of the national committees responsible for the approval and pricing of medicinal products. The present article summarizes the events from 1992 in Italy when the revelation of corruption in the healthcare system and the pressure of public opinion obliged the authorities to make drastic changes in the pharmaceutical policy, and also introduces and discusses the reactions and the impact of such changes on pharmaceutical expenses and drug utilization over the following years.
1978年意大利国家医疗服务体系的出现，也促成了一份免费分发药品的处方集的编纂。在随后的几年里，随着新药的引入，处方集的规模不断扩大，药品费用也随之稳步上升，在1992年达到顶峰。在费用达到峰值之前的几年里，普遍存在腐败现象，涉及多名政府公务员甚至卫生部长，以及负责药品审批和定价的国家委员会的几名成员。本文总结了1992年以来意大利的事件，当时医疗体系腐败的揭露和舆论压力迫使当局对药品政策进行大刀阔斧的改革，并介绍和讨论了这些改革在接下来几年里对药品费用和药物使用的反应及影响。
