“The euro per prescription fee is technically better than the Spanish copayment reform”

The Constitutional Court has declared the prescription fee as unconstitutional but has backed the Catalan judicial fees. It has therefore partially accepted the appeal presented by the Spanish Government against the Catalan Government enforcing both taxes. The prescription fee has been suspended by the Constitutional Court since January 2013, almost a year after it was passed by the Catalan Parliament. “The prescription fee came out before the reform of the Spanish copayment and technically it is much better thought out”, stated Jaume Puig-Junoy, lecturer in public sector economics at UPF and director of the Master in Health Economics and Pharmacoeconomics at UPF Barcelona School of Management.

“Copayment isn’t a large source of finance in any EU country: the best copayments tend to be small ones. The prescription fee had just as much of an effect on the decrease in the number of prescriptions, as the high Spanish copayment for the retired and working population”, he assures. The Catalan Government made 45.7 million euros in the first half year of enforcing it. The Department of Health then emphasized that in the second half of 2012 -with the fee applied-, there had been a 21% decrease in the number of prescriptions. “Other more efficient methods should be found for managing medications: shared risk contracts, coverage and prices depending on cost-effectiveness, no payment if it has no added value for health, prioritizing treatments depending on how effective they are scientifically proven to be, reviews on usage, incentive for treatment adherence in chronic cases...”. Lecturer Puig-Junoy considers that any financial effort made for health care on a basis of fiscal co-responsibility with autonomous governments should be respected, while abolishing the State model based on “I’ll let you have it -State Government- but you can pay -Autonomous Governments-” that currently rules the financial decisions and prices of new medication”.

In 2012 Jaume Puig-Junoy published his book “¿Quien teme al copago?” El papel de los precios en nuestras decisiones sanitarias.” (Who fears copayment? The role that price plays in our healthcare decisions).