# Italian pharmaceutical spending and supply chain stability

> Live situation record from CLSTR: https://clstr.news/situations/italian-pharmaceutical-spending-and-supply-chain-stability
> Updated: 2026-10-20T02:20:00.000Z. Sources: 38. Developments: 3.

The Italian Medicines Agency (AIFA) has released reports detailing fiscal and structural challenges within the national pharmaceutical sector. Earlier monitoring from early 2026 revealed a significant spending deficit in direct pharmaceutical purchases, which exceeded its budget ceiling by 950.6 million euros. AIFA attributed this primarily to spending on non-innovative drugs, even as the pharmacy-dispensed medicine channel maintained a surplus.

By late September 2026, AIFA’s focus expanded to address medicine availability and supply chain vulnerabilities. While the agency noted that current shortages do not constitute a “widespread health emergency”—with fewer than 2,600 medicines listed as scarce and nearly 2,000 having available therapeutic equivalents—it highlighted strategic risks in the global supply chain. Specifically, the report pointed to a heavy reliance on Asia for 60% to 80% of active pharmaceutical ingredients (APIs), noting that China and India control approximately two-thirds of global production capacity.

Economic pressures also persist within the sector. While the Italian generic and biosimilar market reached 6.8 billion euros in revenue, profitability fell to 2.8% in 2025 due to a 32.1% increase in production costs between 2020 and 2024. To bolster healthcare sustainability, officials are emphasizing the role of generic and biosimilar medicines, which are projected to save the public healthcare system 1.2 billion euros between 2026 and 2028. However, experts note that Italy currently lags behind other European nations in the utilization of these cost-effective options, prompting calls for improved professional training and public information to address quality stigmas.

## Claims

- Drug shortages in Italy do not currently constitute a health emergency. (corroborated by 7 sources)
- Fewer than 2,600 drugs are on the shortage lists as of September. (corroborated by 6 sources)
- Nearly 2,000 of the listed drugs have equivalents or therapeutic alternatives available in the national market. (corroborated by 6 sources)
- The profitability of accessible medicine companies fell to 2.8% in 2025. (corroborated by 4 sources)
- Production costs for accessible medicine companies increased by 32.1% between 2020 and 2024. (corroborated by 4 sources)
- The use of equivalent drugs is expected to save the public treasury 1.2 billion euros between 2026 and 2028. (corroborated by 3 sources)
- Italy ranks among the last European countries for the utilization of equivalent drugs. (corroborated by 3 sources)
- Between 60% and 80% of active pharmaceutical ingredients (APIs) used in Europe come from Asia. (corroborated by 2 sources)

## Timeline

### 2026-10-20: Italian pharmaceutical spending reaches €6.78 billion in Q1 2026

Italian pharmaceutical spending hit €6.78 billion in Q1 2026, a 7.6% annual increase that exceeded the programmed budget due to high direct purchases by public health facilities.

2 sources. https://clstr.news/cluster/italian-pharmaceutical-spending-reaches-678-billion-in-q1-2026

### 2026-09-28: Italy pharmaceutical sector faces supply chain fragility and rising costs

Italy faces pharmaceutical challenges as rising production costs and global supply chain dependencies threaten medicine availability and industry profitability despite the availability of generic alternatives.

36 sources. https://clstr.news/cluster/aifa-report-addresses-italian-drug-shortages-and-supply-chain-fragility

### 2026-09-27: AIFA reports pharmaceutical spending deficit in Italy

AIFA reports that Italian pharmaceutical spending for January-February 2026 totaled 4,529.7 million euros, showing a significant deficit in direct purchases but a surplus in pharmacy-dispensed drugs.

2 sources. https://clstr.news/cluster/aifa-reports-pharmaceutical-spending-deficit-in-italy

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Cite as: Italian pharmaceutical spending and supply chain stability. CLSTR, https://clstr.news/situations/italian-pharmaceutical-spending-and-supply-chain-stability