Gestión de la prestación farmacéutica y compras públicas en la Comunidad de Madrid

Total health care expenditure in Spain reached 100 billion € (9.3% of GDP) in 2017, where public health expenditure accounted for 71% of it, which in turns almost a quarter was due to pharmaceutical provision (62.54% patient prescriptions; 37.46% hospital purchasing). Pharmaceutical provision is ruled by Autonomous Communities or regions in Spain and it encompasses actions driven to promote rational use of medicines. It is carried out at drug stores, at the primary care setting and at hospital pharmacy departments. Being budgets systematically limited, and grounded on improved databases, planning and implementing programs as well as centralized drugs and medical devices purchasing procedures, represent two key strategies in Madrid Community. This article defines the implementation of some of the abovementioned programs (prior analysis, professionals’ involvement, training programmes and monitoring). Furthermore it also describes centralized purchasing models to ensure homogeneity, competitiveness and efficiency, in line to current legislation.