ABSTRACT
This chapter discusses pricing and reimbursement policies in Spain. It details the healthcare system in Spain, followed by a more extensive overview of the pharmaceutical market. The chapter offers some information on pharmaceutical expenditure in Spain. It explores the institutional design of pharmaceutical policies in Spain. The chapter also discusses the pricing and reimbursement system in Spain, differentiating between policies aimed at the supply and demand sides, respectively. It shows that Spanish National Health Service is an important factor driving pharmaceutical policy, especially for demand-side policies, given that pricing and reimbursement of medicines, as well as licensing, remain the responsibility of the national government. The chapter focuses on the potential existence of regional heterogeneity across the Spanish regions, especially in terms of public pharmaceutical expenditure. It turns to the proportion of pharmaceutical expenditure borne by patients. The chapter presents the important role of discounts, and the non-existence of claw-back mechanisms for the Ministry of Health.
