TAKE THE MEDICINE, BUT NOT TOO MUCH!

ONE of the things that the public expect from their politicians is a reduction in taxes and to obtain that there presumably should be a reduction in expenses paid by the government. However a reduction in services or their quality is not to be accepted in order to pay less. One of the ongoing problems of the Balearic Government is the rising cost of their pharmaceutical bill. Since 2001 this responsibility has been in the hands of the local departments of health instead of the national ones. Amazingly enough the socialist minister for health for the Balearics at that time was also the proprietor of an important chemist's that supplied a ‘succulent' amount of medicines to the locally run hospitals, something that was not deemed out of order by the local parliament. How strange! Now the conservative minister has been working on what has been called a Shock Plan to reduce public expenditure on pharmaceuticals. The annual increase in the Balearics is greater than the national average. Between October 2002 and October 2003 this was 7.3 percent compared to 4.7 percent respectively, with over a million prescriptions per month. Naturally the population of the Balearics has risen too and represents the Autonomous Community with the highest proportional increase in Spain. This reason for an increase in prescriptions cannot be avoided but what can be combated is the cost of these prescriptions. The central Spanish government has already started a campaign for the use of what are called generic medicines. These are ones “without a brand” that are copies of original medications that no longer have an exclusive patent and are much cheaper. Now the Balearic Government has made a list of medicines with a fixed reference price for the doctors. This is not surprising since their yearly expenses for medicines represents 11 per cent of the Community's annual budget. As an added incentive for the doctors, the “Govern” has created a bonus system whereby doctors may earn an incentive of between 900 and 6'000 euros per year if they manage to reduce the cost of the pharmaceutical bill. In this way they hope to combat the aggressive marketing by pharmacy company reps who visit doctors almost daily with a view to recommending new medicines. Government representatives do not doubt the “integrity of our doctors” and do not suspect that they accept commissions. However it is known that companies do offer attractive invitations to informative conferences on their products. A bonus could make such an invitation superfluous. But who will suffer? The patient? Will there not also be a tendency to actually reduce the number of prescriptions, not only to recommend cheaper products? Will the doctors try to encourage patients to take the medicine but not too much? Perhaps the spoonful of sugar will be for the doctor and not to help the medicine go down!