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The Tuscany Region cuts prescription drugs. But is it legitimate?

Question by the parent company of Forza Italia Marchetti in the Regional Council: "In the name of saving, it is becoming increasingly difficult to cure and heal"

Tuscany Media News – 02/08/2018

FLORENCE — “The Region makes it increasingly difficult to treat and be cured, also by limiting prescription drugs and directing the doctor's therapeutic choice even through the management software. All in the name of savings. But we are not there and we also have the doubt that it is not so legitimate ”. This was written in a note by the leader of Forza Italia in the Regional Council Maurizio Marchetti referring to a resolution of 23 July in which the regional council indicates to the healthcare companies the objectives of containing pharmaceutical expenditure.

There are many limitations on consumption and, therefore, even before that, on prescriptions: "Among the Indicators of territorial pharmaceutical prescriptive appropriateness for cost containment - reads the question - there are limits on consumption for expired patent medicines, equivalent and then again antibiotics, antidepressants, painkillers, cortisteroids, antipsychotics”.

"The Council of State itself has pronounced itself negatively with respect to the Regions which advise against the use of some drugs rather than others - Marchetti continues - Therefore it would not be legitimate to influence, with different pharmaceutical policy choices inspired by the mere containment of health , the doctor's choices in prescribing a drug that has already been assessed as suitable, especially for the treatment of serious illnesses. But since in Tuscany we are always on the hunt for firsts, here too the Asl Toscana Centro is involved, which as far as we know gives a further squeeze, and above all the management software which, at the time of the prescription, shows the awarded products as a priority. It does not seem correct to us, just as we dispute that one should be imposed on patients who already have their own therapeutic protocol switches towards potentially less effective therapies.

"We want to know how many and which tenders were held in 2016 and 2017 for biosimilars, whether there were joint tenders for the "originator" drug and its biosimilar and if so, the percentage of cost savings achieved - Marchetti asked in the question to the regional council – We also want to know if this software management system is legitimate or if instead it does not constitute an imposition and technological manipulation on therapeutic choices for the mere purpose of saving, from which company the prescription management system is supplied for the various Ausl of Tuscany and whether the councilor intends to continue with this choice also in the light of the recent sentences of the Council of State and the appeals of the representatives of the patients not to carry out the "switch" between drugs in their therapeutic plans ".

Finally, in the conclusion of the question, Marchetti asks "whether the indicators of consumption limits and the exclusive software display of drugs indicated in the resolutions referred to do not contravene the principle of prescriptive and therapeutic freedom and constitute a violation of article 32 of the Constitution ”.

Forza Italia is preparing to project an act similar to the question presented by Marchetti to the Chamber of Deputies as well.

Related news: Press release 2 August 2018 – Marchetti

Deliberate. Provisions of the economic objectives for the containment of the pharmaceutical expenditure for the year 2018 – Attachment A 2018 Objectives

Tuscany Region: from 130,000 to 147,000 euros a year for a general manager, where are the savings?

Florence, ASL Toscana Centro to doctors on drugs: prescribe cheaper biosimilars

Biosimilars. Tar rejects resolution of Basilicata: "The logic of saving cannot limit the prescriptive freedom of the doctor"

Biosimilar and "originator". Council of State: "Purchase tenders with a single reference price are legitimate"

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Fedaiisf Federazione delle Associazioni Italiane degli Informatori Scientifici del Farmaco e del Parafarmaco