The Council of Ministers approved this Tuesday a reform of the pharmaceutical co-payment that changes the income brackets for workers and pensioners and introduces progressive monthly caps to limit spending on medicines. The royal decree, promoted by the Ministries of Health and Finance, has an estimated budgetary impact of 265.63 million euros.
The main novelty corrects one of the frictions of the model in force since 2012. Although contribution percentages of 40%, 45%, 50% and 60% are maintained, a part of the contributors who until now assumed the payment without a monthly brake will have concrete limits, after technical reports warned of interruptions or reductions in treatments for economic reasons.
The new decree expands from three to six the brackets for active individuals
The system for active people and their beneficiaries goes from three to six income levels. Those who earn up to 9,000 euros will maintain a 40% co-payment and will have a monthly maximum of 8.23 euros.
On the next step, rents from 9,000 to 17,999 euros will pay that same 40%, but with a cap of 18.52 euros per month. From 18,000 euros up to 34,999 euros, the contribution rises to 45% with a monthly limit of 61.75 euros.
From 35,000 euros, the system again separates situations. Incomes from 35,000 to 59,999 euros will pay 45% with no monthly limit, while incomes from 60,000 to 99,999 euros will assume 50% of the cost, also with no cap.
Above 100,000 euros annually there are no changes in the percentage. That group will maintain a 60% co-payment and will continue without a monthly limit.
Mónica García, minister of Health, maintained that the new system adapts the copayment to the reality of many families that until now were penalized by the model in force since 2012.
Pensioners will keep 10% in the two lowest brackets
For pensioners, the reform establishes four levels. Incomes below 18,000 euros will pay 10% of the drug price with a monthly maximum of 8.23 euros.
Between 18,000 and 59,999 euros, pensioners will maintain that 10% with a cap of 13.37 euros per month. The next bracket, for incomes from 60,000 to 99,999 euros, sets a limit of 18.52 euros per month.
The highest step retains the highest contribution. Pensions over 100,000 euros will continue with a 60% copayment and a monthly maximum of 61.75 euros.
The reform also maintains the exemptions already in force for beneficiaries of the minimum vital income, recipients of non-contributory pensions, unemployed individuals without benefits, minors with disabilities, and persons affected by work accidents or occupational diseases.
Health adds a new exemption and assumes a cost of 265.63 million
A new group is expressly incorporated into that list. Beneficiaries of the child support supplement will be exempt, an inclusion that expands coverage compared to the previous scheme.
The Advisory Committee on Pharmaceutical Provision notes in its technical reports that certain co-payment levels can lead to the interruption or reduction of treatments for economic reasons. That diagnosis accompanies the modification approved by the Government.
The estimated budgetary impact of the reform amounts to 265.63 million euros.