There are giants, such as Johnson & Johnson Medical, which will have to shell out almost ten million euros. 9.8 to be precise. Twenty-six other companies all received a bill exceeding one million: ranging from 8.1 million from Medtronic Italia to 1 million and 100 thousand euros from Becton Dickinson, a supplier of reagents for example. The total figure is frightening: almost 128 million, which the Region now expects from private companies in the medical sector as a result of a law called “payback sanitario”. Payment terms are tight: January, first “warning”. And the reference years aren’t even those of the pandemic, when public spending skyrocketed: the data we are talking about, in fact, are 2015, 2016, 2017 and 2018. This is extra money spent by the service public health sector that the supplier companies must now return to Friuli Venezia Giulia as a result of a bitterly contested law. But still existing. The risk? There is and it is high. Especially private individuals who are not international giants may not be able to pay.
WHAT’S UP
The Central Health Directorate of Friuli Venezia Giulia has done nothing but apply the law. With a communication via certified mail, the “beat” was delivered to 1,206 companies in mid-December who, in the four reference years, supplied medical materials (equipment and various products) to local health authorities or to the regional coordination agency. Inside there is everything: ranging from the most sophisticated devices, such as the life-saving equipment of hospitals that are supplied by the large multinationals in the sector, up to the small instruments supplied to any doctor. From a few euros to almost ten million spread over four years. All this why? Because the regional expenditure ceiling relating to the supply of medical devices has been exceeded. A mechanism not so different from the one that is set in motion with regard to pharmaceutical spending. Currently, 50 percent of the excess expenditure made by the Regions is charged to the manufacturing companies compared to the 4.4 percent ceiling of public expenditure foreseen for medical devices.
THE SYSTEM
The state law dates back to 2015. For the first time, however, the bill really comes to the companies that over time have supplied the Regions (in this case to Friuli Venezia Giulia) with medical devices of varying complexity and importance. The institution administered by Massimiliano Fedriga counts on payments of almost 128 million euros, while in Veneto the account has shot up to more than 220 million. Private companies, as a result of the payback mechanism, are forced to return a share of the expenditure overrun for medical devices. And this share, for 2017, even reached 50 per cent of the deviation itself. The remainder of the increased expenditure, on the other hand, remains borne by the regional budgets, already weighed down with regard to the chapters related to health.
There are now two problems: companies, through trade associations, are thundering against a system that obliges them to pay – in short order – figures that are difficult to bear especially for the smallest companies; the Region, on the other hand, counts on the quota of this allotment in order not to burn further resources and to plan the health activity. Of course, for now, there are numbers. And the millions of euros.