[The impact of drugs on social welfare. 2008 SESPAS Report]

The reasons and rationale for state intervention in the pharmaceutical industry are discussed with emphasis on two of the most frequent perspectives: the health-focused view and the income-centered approach; these perspectives tend to be ignored, to come into conflict, or to be confused in Spain. The growing impact of drugs on health and on the productivity of a knowledge-intensive industry - such as the pharmaceutical sector - is discussed. The impact of drugs on welfare will depend on how prescription is dealt with within the framework of some macro policies that could clearly be improved. The present article focuses on the effectiveness of Spanish pharmaceutical policy and assesses three families of policies. Several recommendations are made: greater use of price competition, regulatory signals rewarding the most innovative drugs (those that offer the greater incremental cost-effectiveness with respect to the already existing alternatives), a shake-up of the national system of innovation, and the indispensable alignment of prescriber incentives and the health system. An integrated pharmaceutical policy would help to bridge the quality chasm of the Spanish health system by making it more desirable, and therefore sustainable.