Overview

• An audit of 2022 spending in Cantabria, Extremadura, Murcia and La Rioja found up to 97% variation in the price paid for identical medications across four public hospitals.
• All audited hospitals bypassed public contracting rules when acquiring medicines, with Marqués de Valdecilla conducting 99% of its €101 million pharmacy purchases off-protocol and other centres overusing minor contracts beyond legal thresholds.
• The report identifies gaps in pharmaceutical management, including absence of standardised prescribing and dispensing protocols and outdated IT systems for tracking drug expenditures.
• Insufficient budget planning delayed payments to drug suppliers and generated interest charges, while only Cantabria’s health service budgeted specific indicators for hospital pharmacy costs.
• Hospital drug outlays reached €8.79 billion in 2022 and rose 8.05% in 2023, prompting calls for unified procurement frameworks and adoption of unit-dose acquisition models to improve sustainability.