Italian Medicines Agency Agenzia Italiana del Farmaco

AIFA monitoring of final data for January-December 2024 - AIFA monitoring of final data for January-December 2024

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AIFA monitoring of final data for January-December 2024

After acquiring the final expenditure data from the Regions, the 2024 final balance closes with an overspend on pharmaceutical expenditure for direct purchases by the Regions of 4 billion and 16 million euros. This figure is slightly higher than the 3.7 billion euros overspend calculated at the end of April on the basis of provisional data. The “Monitoring of National and Regional Pharmaceutical Expenditure January-December 2024”, approved by the AIFA Board of Directors at its meeting on 29 July, sets expenditure for direct purchases at 11.32% of the National Health Fund (FSN), compared to the 8.3% ceiling set. Last year, the percentage of expenditure on the FSN was 10.53%. In addition to the dynamics recorded in other comparable countries, such as an ageing population and increasingly high innovation costs, the increase in expenditure was also influenced by the transfer of several medicines from the Innovative Medicines Fund to the Direct Purchases Fund.

The document, published on the AIFA portal, also highlights a significant divergence in spending at regional level, with a percentage compared to individual regional health funds ranging from 9.44% in Lombardy to 13.48% in Sardinia, from 13.21% in Campania to 13.15% in Friuli Venezia Giulia. In addition to Lombardy, Trento and Valle D'Aosta also fall below the 10% threshold of the FSR, while Emilia Romagna, Abruzzo and Marche are above the 12% threshold.

Overall, in absolute terms, expenditure on direct purchases by the Regions amounts to €15.056 billion, to which €249 million in expenditure on medicinal gases must be added.

On the other hand, expenditure on pharmaceuticals purchased under approved care regime recorded a surplus of €691 million, which, net of discounts paid by pharmacies and gross of prescription charges, amounted to €8 billion 353 million, against a planned ceiling of 6.80% of the Health Fund (equal in absolute terms to €9 billion 44 million). In percentage terms, the incidence of pharmaceuticals under approved care regime on the Fund was 6.28%, compared to 6.34% in the 2023 National Health Fund.

Net of pay-back, expenditure on innovative medicines amounted to €775 million, entirely covered by the ad hoc Fund, amounting to €1.3 billion. This resulted in a surplus of over €500 million, which could have been used to reduce the overspending of the 2024 direct purchase ceiling and which will now be reallocated in 2025 thanks to the decision on innovative medicines already approved on 12 July 2025.


Published on: 30 July 2025

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