Spain is a parliamentary monarchy and a highly decentralised state, organised into 17 autonomous communities and two autonomous cities. Healthcare is delivered through the tax-funded National Health System (Sistema Nacional de Salud, SNS), which aims to provide near-universal coverage and a comprehensive benefits package. Most care is provided in the public sector and is generally free at the point of use.
The national government, through the Ministry of Health, sets the overarching framework for entitlements and coordination. The autonomous communities hold the main operational responsibilities for healthcare, including planning services, allocating resources, purchasing, and organising provision through their regional health services. Coordination between national and regional levels is supported by the Interterritorial Council of the SNS (Consejo Interterritorial del Sistema Nacional de Salud).
National-level pharmaceutical policy defines the broad rules for coverage, including the common benefits package and national approaches to outpatient prescription co-payments. However, the autonomous communities play a material role in real-world access because they manage medicines budgets and implementation and may apply additional regional or local measures that influence availability and uptake, particularly for hospital medicines.
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In this section subscribers can consult descriptions of the following stages of the national access process, with links to key sources of additional information:
- Healthcare system
- Access landscape
- Horizon scanning
- Scientific advice
- Regulatory approval
- Health technology assessment
- Price setting and rebate system
- Early access opportunities
- Additional funding opportunities
- Innovative medicines