Regulatory Ambivalence and the Limitations of Pharmaceutical Policy in Spain

Broadly speaking, pharmaceutical policy in Spain has been unable to control either the price or the volume of drugs prescribed. Limited attempts have been made to bring together the regulation of the pharmaceutical market and policies, in pursuit of the desired goals of efficiency and quality. This paper assesses the regulation of the Spanish pharmaceutical market over the last two decades by examining regulation and policy and the available empirical evidence on their appreciable effects, and presents recommendations for policy design. Our findings suggest that policies aiming to improve efficiency and quality have not managed to contain costs, while costeffectiveness is still overlooked. We argue that future policies should encourage broader participation in the decision-making processes and promote a higher degree of competition, especially from generic drugs.