Changes in the co-payment of medicines: it will be limited to 61 euros for incomes below 35,000 euros
The Spanish government approves new tranches in pharmaceutical co-payment to prevent vulnerable patients from abandoning treatments
The Council of Ministers has approved this Tuesday a reform of the pharmaceutical co-payment system to make it more proportional to income. The idea is to incorporate a cap on the contribution of patients earning less than 35,000 euros per year, who today have no monthly limit on the expense of medicines financed by Social Security. In fact, the reform – which must first go through Congress – introduces four new contribution brackets and progressive monthly caps to benefit middle and low incomes, while aiming to prevent the abandonment of treatments for economic reasons. The Ministry of Health calculates that the savings for families will be around 265 million euros, although for the moment there is no date for the implementation of the new model.
abandonment of treatments for economic reasonsCurrently, the income brackets for co-payment are three: incomes below 18,000 euros, who pay 40%; those between 18,000 and 100,000, who pay half, and those over 100,000, who pay 60%. The big novelty approved by the Spanish government is that incomes below 35,000 euros will have a spending limit on the pharmaceutical bill.
Specifically, for employed individuals with annual incomes below 18,000 euros, the lowest contribution (40%) is maintained, but two different caps will apply: a maximum of 8.23 euros for patients earning less than 9,000 euros and a maximum of 18.52 euros for those earning less than 18,000 euros. This is a measure primarily designed to ensure the continuity of treatments for chronic patients.
Also, for incomes between 18,000 and 34,999 euros, the co-payment will remain at 45% and the monthly expense will be limited to 61.75 euros. The same percentage (45%) is set for those with incomes between 35,000 and 59,999 euros, although they will not have a cap.
A fifth tier for incomes between 60,000 and 100,000 euros stipulates that 50% of the medication cost will be paid, while those who exceed this last amount (the sixth tier) will continue with 60%, with neither of the two tiers having monthly caps.
A new tier for pensioners
With the current system, pensioners share the same tiers as active individuals, although with different monthly caps, which are 8.27 euros, 18.52 euros, and 61.75 euros in each bracket, respectively. In contrast, with the reform, there will be four tiers for pensioners: the tier of less than 18,000, the tier from 18,000 to 59,999, and the tier from 60,000 to 99,999, which will continue to cover 10% of medication up to a monthly cap of 8.23 euros, 13.37 euros, and 18.52 euros, respectively. For those with pensions exceeding 100,000 euros, the co-payment percentage remains at 60% up to a maximum of 61.75 euros per month.
Likewise, existing exemptions for vulnerable groups are maintained, such as beneficiaries of the minimum vital income, recipients of non-contributory pensions, unemployed individuals without benefits, minors with recognized disabilities, or those affected by work accidents and occupational diseases. The exemption for beneficiaries of the child aid supplement is also expressly incorporated.