Objectives:

High economic impact medicines (HIM) are challenging health services of the European countries. Nevertheless, there is no consensus on what constitutes a HIM. The aim of the study is to compile a list of HIM dispensed by Spanish hospital pharmacy services and to analyze the situation regarding those medicines in Spain.

Methods:

Drugs with a cost higher than €10,000 per year (HCM) or high volume of consumption (HVM) were considered HIM. The ex-factory price (PVL) per defined daily dosage or prescribed daily dose was calculated.

Results:

A total of 147 active ingredients were HCM, corresponding to ATC code: L (69.4%), J (10.9%) and A (10.2%). Mean daily PVL of HCM was € 218.6 (28.6-2,892.5). 38.8% were innovative drugs, 26.5% were orphan products and 34.0% were biological drugs. A total of 16 medicines (5.8%) were priced more than € 10,000/pack. The HVM belonged mainly to group L (45.0%) and J (35.0%). Average daily PVL of HVM was € 154.4 (1.1-1,629.3). 35% were first-in-class drugs, 5% orphan medicines and 60% biological drugs.

Conclusions:

This study shows that a large number of HIM are dispensed by the hospital pharmacy services, mainly antineoplastic and antiinfective drugs. Although the minimum daily PVL to consider a medicine as HCM was € 27.4. The average daily price of HCM was >€ 200. However, given the high consumption of some drugs, medicines with a daily cost as low as € 1.1 can be considered HIM. A new category of HCM, ultra-premium-priced medicines, could be established for drugs with a cost higher than € 10,000 per pack.

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