The Pharmaceutical Sector is at Default Risk. A Proposal to Re-Establish the Economic Balance and Define a New Governance

The pharmaceutical governance in Italy is provided by a cap applied as a percentage of the National Health Fund to the territorial (11.35%) and hospital expenditure (3.5%). The amount of overspending is charged to the pharmaceutical companies with a payback procedure. For the years 2014-2016 the overspending is estimated at about 3.8 billion euros, which is likely to result in a system default. In this article a new pharmaceutical governance is proposed and discussed; its aim is to avoid financial imbalance and to identify appropriate measures to bridge the gap between the very high prices of new/innovative drugs and the system sustainability.