From drugs to medical equipment: spending on purchases runs like in the times of Covid

A new red light is on in the area of ​​state healthcare spending. Thanks above all to a jump of over 37% in one year alone for the item "pharmaceutical products" - in a broad definition that ranges from medicines in the strict sense to reagents to vaccines and some devices - all public administrations, not only those closely linked to the National Health Service, have spent amounts on healthcare supplies that have not been seen since the darkest years of Covid when, driven by the emergency, spending had exploded to unprecedented levels.

An alarm bell that clearly emerges by lining up the numbers present in the National Anti-Corruption Authority database of recent years and in particular the latest available: 2024. Last year, the overall economic value of public procurement in Italy was almost 272 billion euros, with a decrease of 4.1% on 2023 and 7.3% on 2022, mainly due to the boom in PNRR procurement in the two previous years. Public contracts relating to pharmaceutical products, on the other hand, behaved in complete contrast, increasing compared to the previous year by 37.2% for a value that almost reaches 41 billion euros. If we also add to this item the 21.750 billion of purchases of medical equipment - again with a broad definition that goes from needles to heart valves to CAT scans and ultrasounds - then the total almost reaches 63 billion in total expenditure, a level that is close to that reached during the pandemic: if in 2020, when Covid appeared, expenditure for these purchases was still at 47.6 billion, the following year it had reached 58.8 billion and then shot up to 65 billion in 2022, to fall the following year - with the emergency practically over - to 50 billion. Now in 2024 the new important leap (especially in the pharmaceutical products category) in expenditure that reaches almost 63 billion, a figure very far from the pre-pandemic period when healthcare purchases stood at 40 billion. Of course, the numbers for procurement must always be taken with some caution - between dragging out multi-year tenders and the fluctuating effect of the PNRR investments -, but the upward trend seems clear and is certainly very worrying for a period no longer marked by the rush for masks and vaccines. "Based on the information on public contracts, contained in the Anac Database, it emerges that spending on the purchase of pharmaceutical products in Italy has settled on the values ​​of the Covid period", confirms the president of the Authority Giuseppe Busia. Who underlines how in "a comparative analysis of supplies, in Italy in 2024 the first two items concern pharmaceutical products and medical equipment for a total value of almost 63 billion in public spending, when in 2019 it was 40 billion. If the drop in public contracts for pharmaceutical products in 2023 can be explained by the end of the Covid pandemic, the subsequent rebound in 2024 shows that spending on pharmaceutical products has started to grow again. In the 2024 comparison of public supply contracts, the third item after pharmaceutical products and medical equipment, are the expenses for heating and electricity which reach 5 billion, compared to the 63 of health expenditure». For Busia it is however «positive to note that the bulk of purchases of pharmaceutical products occurs through central purchasing bodies, which aggregate purchases and allow the public body to save money».

Health Minister Orazio Schillaci has also been saying for some time that healthcare spending has become increasingly difficult to manage, and in the bill on healthcare services currently being examined by the Senate he includes measures to try to stem, for example, the waste of too many prescriptions and prescriptions that are not always necessary: ​​"Recent data, sampled from the regions, tell us that up to 30% of prescriptions issued are inappropriate. This is a phenomenon that must be monitored carefully and fought. It is important that citizens take the tests they need and when they really need them."