These are the ten most frequently prescribed drugs in Andalucía's public health system

Pharmaceutical spending in the Andalucía region of Spain in 2025 will account for "practically a third" of the budget of the Servicio Andaluz de Salud (SAS) Andalusian public health service.

Issues such as the increase in the number of patients, an ageing population and lifestyle habits are among the factors behind this increase, which includes both medicines purchased by patients in pharmacies - on prescription - and those administered in hospitals and health centres.

Of these, analgesics and antipyretics stand out in terms of the number of prescriptions. Paracetamol is the painkiller most commonly found in Andalusian households, with 8.3 million packs dispensed between January and October.

To that can be added the 5.6 million boxes of metamizole (active ingredient of Nolotil) and the 3.6 million packs of acetylsalicylic acid, showing that of the ten most prescribed medicines in Andalucía, those for pain and fever account for more than a third of prescriptions.

Andalusian data falls in line with national statistics in Spain, where according to a report by the ministry of health, 12% of Spanish prescriptions are for painkillers. The second most widely used medicine in Andalucía is omeprazole, with almost eight million packs accumulated during the first ten months of the year.

However, the contained price of these drugs does not translate into large amounts beyond the logical cost associated with the quantity. Paracetamol, in any of its presentations and brands, accounts for 19.1 million, which is less than half the coverage of atorvastatin - Atrolip, Cardyl, Zarator... - , which is the ninth most popular in terms of dispensing. In this case, to correct blood cholesterol and cardiovascular diseases.

The biggest chunk out of the budget goes to medicines for diabetes, even if they are not particularly widely prescribed: of the ten most expensive medicines, eight are for diabetes.

According to SAS data, the medicines Forxiga 10mg, Ozempic 1mg, Jardiance 10mg, Trajenta 5mg, Toujeo (300 units), Trulicity 1.5 mg, Rybelsus 14 mg and Synjardy 12.5 mg cost 175 million euros.

In the same period in 2023, the total was 147 million. In fact, spending on drugs for diabetes has risen between 25% and 30% in the past five years, according to SAS data.

The ministry of finance pointed out that up to September - the latest accumulated data - 3,775,956 euros had been invested in Andalucía in pharmaceutical spending, 6.8% more than the same time in 2023.

The highest expenditure was on pharmaceuticals and medical devices by prescription or dispensing order, which accounted for 1.83 million up to September. This was, interestingly, the most modest increase (3.1%), when compared with the previous period. The swing was felt much more in hospital pharmaceutical spending, which experienced a year-on-year rise of up to 10.3% with 1,123,830 euros.

The treasury report shows that the Andalusian percentages are below the average for all Spanish regions. The Andalusian percentages are below the average in all cases except for the year-on-year variation in health products without medical prescription or dispensing order. While in the regions as a whole it is 9.8% more than in 2023, in Andalucía, the proportion rises to 10.9%.

This refers to a group of articles including sample containers for in vitro diagnostic, such as blood and tissue donations to certify a physiological or pathological condition, a congenital anomaly or the viability of the patient as a recipient. Also included are medical devices that regulate conception, those that diagnose or alleviate an injury, custom-made products indicated by medical practitioners, accessories for joint use with other products and those intended for clinical research.

Painkillers now accounting for a third of the SAS budget is borne out of trend over the past decade. According to the ministry of finance, in 2014 Andalucía spent 2.9 million euros, which five years later rose to 3.6. There was then an exponential leap in 2020 and in 2021 - with 4.1 and 4.5 million, respectively.

Since then, the amount has only increased, although, according to the Junta, in recent years the rise has been more moderate to the point that between January and October it has been "the region that has increased its pharmaceutical spending the least".

To continue this downward trend, measures such as a joint action on patients with 'prescription opioid addictions', including referrals to treatment centres for withdrawal or pain units, will be implemented in 2025; as well as an incentive programme for review of polymedicated patients, the limitation of the duration of certain treatments, the promotion of generic or the "incorporation in electronic prescriptions of a system to help prescribers to prevent the prescription of doses higher than the maximum".