[Evolution of pharmaceutical provision in the National Health System (1984-1994)].

OBJECTIVES

To analyse the free pharmaceutical provision of the National Health Service, using the customary indicators.

DESIGN

Longitudinal, retrospective and observational study, embracing the years 1984 to 1994.

SETTING

The provision, using official National Health Service prescriptions, of pharmaceutical products via dispensaries.

PARTICIPANTS

Prescriptions of the period under study.

MEASUREMENTS AND MAIN RESULTS

The measurements for the evolutionary analysis of free pharmaceutical provision were carried out in absolute and relative values. Within the absolutes, public health expenditure on drugs went from 178,348 million pesetas in 1984 to 643,701 million in 1994; and prescriptions from 432 million in 1984 to 494 million in 1994. Beneficiaries' contributions for drugs, as a percentage of overall consumption, went down from 15.75% in 1984 to 9.16% in 1994. The indicators of pharmaceutical prescription placed the cost of sale to the public per prescription in 1994 at 1,446 pesetas, an increase of 195% over 1984, whereas the average expenditure per prescription (1,303 pesetas in 1994) went up by 215%. Expenditure per protected pensioner went from 18,180 pesetas in 1984 to 56,784 in 1994, with an average number of prescriptions per pensioner of 38.04. In this last year the tendency for consumption to fall, begun in 1993. The profiles of the therapeutical sub-groups, which were most consumed in cost terms, displayed large variations.

CONCLUSIONS

The structural management measures adopted during the period under study, especially those for 1993 (new VAT on drugs, Royal Decree on Selective Financing of Medicines) and 1994 (average fall of 3% in the free sale price of drugs, collaboration of Dispensaries) are, in our view, those which have most affected the evolution of this free provision.