ALL regional health authorities across Spain will be required to charge for medication dispensed to outpatients in hospitals from this month onwards after being given a three-month stay of grace.
Whilst the requisite for payment towards hospital drugs was confirmed on October 1, Spain's 17 autonomously-governed regions were given until January 2014 to put a system in place to allow this to happen.
It will affect anyone who has regular hospital consultation appointments for cancer, eczema, hepatitis, psoriasis, rheumatoid arthritis, HIV and AIDS, degenerative conditions, or who has had a transplant.
Certain types of drug used to treat these patients are sold via the hospital dispensary because they are rare and expensive, and not readily available at mainstream high-street pharmacies.
Now, anyone prescribed these during their outpatient appointments will have to pay up to 10 per cent of the recommended retail price, capped at 4.26 euros.
In October when the law was changed, the maximum payable was 4.20 euros, but it has now been increased in line with inflation.
A total of 43 types of drug, sold under 157 brand names, are affected.
Treatment or drugs administered in hospital by nurses or doctors during in-patient or outpatient appointments are not affected, meaning cancer patients who attend regularly for chemotherapy do not have to pay for the medication supplied during their sessions.
In-patients do not have to pay for drugs given during their hospital stay.
Where a patient has several different types of medication dispensed by the hospital pharmacy and regular outpatient appointments, the cost can mount up considerably and, with so many residents surviving only on the 425-euro-a-month unemployment subsidy, they have to make a choice between paying their rent or mortgage and electricity bills or buying life-saving medication, says the Hepatitis and Transplant Patients' Federation (FNETH).
Members of the opposition parties in government in Spain call the move 'cruel' and 'forcing patients to pay to stay alive', and also claim the amount of money clawed back from the exercise will be a drop in the ocean to the bottom line or even be less than the costs involved in handling payments from patients and keeping records.
Several regional governments have refused to apply the payment requirement, and the Basque Country, Canary Islands, Andalucía and Castilla y León have either already taken legal action to appeal the decision or intend to do so.
Aragón, Catalunya, Extremadura, Valencia and the Balearic Islands have so far refused to apply the measure – some through a conscientious objection and some because they felt the systems would not be in place in time for the January deadline.
Galicia, Madrid, Cantabria, Murcia and La Rioja have already put the payment requirement in place as they consider it not their place to rebel against a State law, and Castilla-La Mancha has done so because its president, María Dolores del Cospedal, is also the secretary-general for the central government of Spain.
The federal regions have until the end of this month to start to apply the new payment obligations.
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