pres pilar farjas abadia, health system reforms during the … · 2013-10-10 · pharmaceutical...

Health system reforms during the economic

crisis: challenges and opportunities for

Spain

SECRETARÍA GENERAL DESANIDAD Y CONSUMO

Pilar Farjas Abadia Secretary General for Health and Consumer Affairs

Ministry of Health, Social Services and Equality, S pain

Oslo, 18th April 2013

Spain

� Financed through national public budget

Features of the Spanish National Health System


� Universal coverage

� Health services free of charge

� Based in primary health care

� Decentralized model: 17 Regions

Evolution of public debt in the National Health System

8.555

15.699

8.000

10.000

12.000

14.000

16.000

173%

How was the situation? (1)


2.170 1.9302.745

4.685

6.369

3.0003.870

5.2305.745

8.555

0

2.000

4.000

6.000

8.000

2009 2010 2011

Mill. d

e €

Source: Data from Farmaindustria, Fenin, IDIS y FEFE

OthersPharmaceutical IndustryTotal

PharmaciesHealth Technology Industries

Evolution of GDP and public health care expenditure(million Euro), 2002-2012



Evolution of pharmaceutical expenditure and of the number of prescriptions, 2003-2012



Pharmaceutical expenditureNº Prescriptions

Health Insurance rights

Basket of benefits

What was done?: Health Reforms in 20121000 700

3550

600


PharmaceuticalPortfolio

Social-Health agreement

Health Professionals

Efficiency Measures

1442

500 500

1000

37 80

100

Estimated savings

Reached savings

In progress savings

(million Euro)

Results in pharmaceutical expenditurePharmaceutical expenditure per month, 2012 vs. 2011 (million Euro)

20112012

Savings


Providers’ payment

Plan

Evolution of hospital pharmaceutical debt, 2008-201 2 (million Euro )

Before Reform

After Reform

Self assessment of health status: good or very good

Performance of the National Health System

70,5 70,174,1 75,0 76,4

83,4 83,8 82,3

12,314,6

18,8 20,0 20,9

28,230,8

28,3

9,2 8,9

20

30

40

50

60

70

80

90

100

Use of health services National Health Survey 1987-2012


year

National Health Survey 2012

12,37,5 7,7 8,2 9,2 8,9 7,9

6,3 6,9

6,3 7,1

0

10

1987 1993 1995 1997 2001 2003 2006 2012año encuesta

92,8

7,2

98,2

11,1

98,2

10,6

98,7

10,1

99,5

11,9

98,3

14,6

99,0

13,4

0

10

20

30

40

50

60

70

80

90

100

1993 1995 1997 2001 2003 2006 2012año encuesta

doble cobertura (pública y privada) cobertura pública cobertura privada

Health CoverageNational Health Survey 1993-2012

2012: 12.5% double insurancepublic-private

75,3%

�Sustainability: The NHS reform has allowedaddressing the debt and obtaining savings withoutprecedent.�Equity and solidarity : Ensures the maintenance ofthe Universal health coverage and the protection of

Reforms Conclusions for Spain


9

the Universal health coverage and the protection ofthe most vulnerable ones.�Consensus: Among Regions in order to beadopted.�Acceptance: The NHS Reform has the support ofthe citizens.� Road Map: The NHS Reform creates the stabilityand the predictable frame needed and request by allthe stakeholders.

Thank you!


Thank you!

http://www.msssi.gob.es/

pres pilar farjas abadia, health system reforms during the … · 2013-10-10 · pharmaceutical...

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