Pharmaceutical assistance: Direct distribution of medicines

Direct distribution is understood as the dispensing, through healthcare facilities, of medicinal products to service for administration at home. While all medicines, with the exception of those for hospital use only, are distributed (sold) in local pharmacies, PHT (Prontuary Hospital-Territory) medicines can be purchased by healthcare companies on a favorable condition and be distributed directly by the public health centres or possibly distributed by pharmacies, which agree with the Province a fee for the service (distribution on behalf). Also drugs distributed within residential facilities, such as nursing homes, prison.. they are considered drugs in direct distribution. In 2015, not considering patients treated in residential facilities, 5.7 % of the population of around 30,000 people received at least one drug directly from the home care facility. The most distributed drugs, in terms of packaging, concern those for the treatment of diseases of the gastrointestinal system/metabolism followed by those for the central nervous system. Within residential structures, however, the distribution of drugs for the central nervous system (over 40 % of total packages distributed) prevails significantly. The active ingredient with the highest direct distribution expenditure recorded in 2015 corresponds to Sofosbuvir (in Italy marketed as Sovaldi) drug for the treatment of hepatitis C, which with EUR 4.1 million in the cost of purchasing the drug represents 7.9 % of the total expenditure. Total expenditure on medicines delivered through public facilities (hospitals, corporate services) amounted to EUR 48.8 million. To these should be added an additional EUR 1.0 million of the service cost for the distribution of part of these drugs through pharmacies in the territory: approx. 122.000 packages distributed directly by pharmacies on behalf of the Health Company. The cost of purchasing medicines distributed within residential facilities is over EUR 2.7 million (more than half of the expenditure relates to the distribution of medicines for patients staying in nursing homes and one third for patients followed in psychiatric centres).