Catalan Government starts refunding drug prescription fee after Constitutional Court ban

Barcelona (ACN).- The fee that was temporarily charged on each drug prescription in Catalonia between June 2012 and January 2013 has started to be refunded by the Catalan Government, after the Constitutional Court definitively banned it in May 2014. The measure, which included many exceptions for chronic diseases and people on low incomes, as well as a 61-euro annual limit, had been adopted to reduce superfluous drug demand in order to decrease the pharmaceutical spending of the public healthcare system, with the final goal being to reduce public deficit and help balance the budget, in a context of great economic crisis and pressure from the EU institutions and financial markets. In the short period the fee was in place, €45.7 million was directly earned but much more was saved, since drug spending dropped by more than 20% for the months it was in place (by 23.9% in November 2012, for instance).

The decision to ban the measure was temporarily adopted in January 2013 by the Constitutional Court, when it accepted an appeal from December 2012 filed by the Spanish Government, run by the People's Party (PP). The PP had initially supported the approval of the measure in Catalonia in spring 2012 but, after the Catalan Government started to back self-determination and independence from Spain in autumn 2012, the conservative and Spanish nationalist party decided to oppose the drug prescription fee as part of its retaliation actions, framed within a global confrontation and recentralisation strategy.

In fact, in the last two-and-a-half years, the Spanish Government has totally opposed almost all the measures and initiatives taken by the Catalan Government, using to a great extent the Constitutional Court, and has increased the recentralisation of powers, reducing the autonomy of the Catalan Executive. However, the drug prescription fee had been quite a controversial measure, rejected by all the opposition parties (including now the PP).

The Catalan Government expects to return €6 million

According to the Catalan Government's calculations, so far 100,000 euros has already been returned to approximately 5,000 people, who requested the refund of about €20 per person on average. Furthermore, the Executive plans that about €6 million will be returned in total. So far, 311,000 people have filed a request, 160,000 of which are already in the process of being refunded. Around 400 requests have been rejected.

By the end of 2014, around 200,000 requests (some 65% of the total so far) had been filed. Citizens will have up to 4 years to file their requests, although the greater number of petitions is expected to be sent in these first few months.

The Constitutional Court's definitive decision came in May 2014, but the Catalan Government needed some time to set up the system through which citizens could send the refund requests. Citizens are requesting amounts ranging from €1 to €61, which was the annual maximum set. Refunding such a fee is quite complex and costly, since it includes the creation of a system to send the requests, deal with them, verify them and refund the person for quite a small amount of money.

€45.7 million was earned with the drug prescription fee and drug spending was reduced by 23.9%

The drug prescription fee brought in €45.7 million in roughly 6 months and the total number of prescriptions was reduced by 21%. In addition, drug spending in Catalonia in November 2012 was reduced by 23.9% compared to the previous year because of this measure and that introduced by the Spanish Government. The Catalan Executive initiative was implemented on the 23^rd of June 2012, after having been approved by the governing centre-right pro-Catalan State coalition CiU with the indirect support of the People’s Party (PP) in the Catalan Parliament on the 20^th of March 2012. Back then, tensions between the CiU and the PP were already starting, despite the fact that they had been parliamentary allies in 2011, mostly due to the recentralisation initiatives from the new Spanish Government.

Besides, the drug prescription fee had previously been validated by the Catalan Council of Constitutional Guarantees (CGE), an advisory body to the Catalan Government on Constitutional affairs, on the 6^th of March.

The Spanish Government appealed the drug prescription fee 

After having supported it in March, in December, the Spanish Executive decided that the drug prescription fee approved in Catalonia was encroaching on its power to rule on pharmaceutical products. In between there was the massive pro-independence rally organised in September 2012 and the Catalan Government’s open support of self-determination.

The Catalan Government – which is called the Generalitat – argued that they could approve such a measure as they exclusively manage the drug prescription system in Catalonia. Furthermore, apart from the jurisdiction consideration, the Spanish Government believed that the measure made residents in Catalonia pay more for their medicine than the rest of Spanish citizens and therefore went against the principle of “equality for all Spaniards”, as the Spanish Minister for Health back then, Ana Mato, stated in January 2013, when she was lauding the Constitutional Court’s decision to call a temporary halt to the fee.

In addition, since the Spanish Government increased the share citizens have to pay for partially-subsidised drugs – a measure adopted after the Generalitat’s initiative, the Spanish Executive said that Catalonia’s drug prescription fee had to be abolished as Catalans are affected by two fiscal measures for the same product.