This retrospective study used linked registry and billing data on Catalan spending on high-impact medicines, 2019–2024. Spending rose 53% nominally and about 30% after inflation, while patients treated rose from 215,182 to 327,455. The top 10 medicines accounted for 43% of expenditure and 30% of treated patients. Managed access measures covered 155 of the 208 indications newly reimbursed in 2022–2024. Agreements with manufacturers held 2024 spending on that year's new indications to €23.6 million, a quantified €7 million saving. The design is descriptive, and savings from several agreements and from prescribing restrictions could not be quantified.
Why it is interesting: Overall spending grew with patient numbers while spending per treated patient fell. It shows which agreements a regional payer used, such as discounts and spending caps, and in which disease areas.
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