Italy's pharmaceutical spending reforms risk up to €1 billion extra cost

A study presented in Cagliari shows that the Sardinia region spends 33% of its reimbursed pharmaceutical budget on equivalent drugs, slightly above the national average of 31.9%. If Sardinia raised its adoption rate to the northern‑Italian average of 46%, it could save about €5 million a year. In 2024, Italian citizens spent over €1 billion on originator medicines that are no longer under patent, representing an avoidable cost of 13.3% of Sardinia’s drug spend.

At the national level, the 2025 drug‑purchase ceiling has already been exceeded by €4.7 billion. To address the overspend, the Italian Medicines Agency (AIFA) is revising the therapeutic formulary and introducing a reference‑price scheme that would reimburse only the lowest‑priced product within each therapeutic class. The measure could affect widely used medicines such as gastro‑protectors, ACE‑inhibitors, sartans, statins and omega‑3 supplements, and may shift up to €1 billion of costs onto patients as a “super‑ticket”. Italy is also part of an eight‑country group that sets reference prices influencing U.S. Medicare and Medicaid. Critics warn of possible drug shortages and highlight cultural and prescribing barriers that limit the uptake of equivalent drugs, including patient doubts about efficacy and physicians’ preference for brand‑name products.