The report ‘Monitoring of national and regional pharmaceutical expenditure January–September 2025’ shows total pharmaceutical spending of 18.42 billion euro over the first nine months, combining community (convenzionata) and direct‑purchase channels, with an overall deviation from the programmed ceilings of 2.85 billion euro. Community expenditure through public pharmacies reaches 6.425 billion euro, equal to 6.33% of the National Health Fund (Fondo sanitario nazionale), while direct purchases by public healthcare facilities amount to 11.811 billion euro, or 11.64% of the fund, net of innovative medicines, selected antibiotics for multidrug‑resistant infections and medical gases.
AIFA underlines that the incidence of both components on the fund has fallen compared with the previous January–June 2025 monitoring, indicating some slowdown in growth, particularly for direct purchases. Nevertheless, direct purchasing remains well above the 8.3% ceiling, driving most of the overshoot, whereas community spending stays close to its 6.8% cap and, in several regions, remains below it.
On the community side, the report records a 0.2% increase in defined daily doses dispensed, equivalent to an extra 41.5 million doses, alongside a 3.2% rise in net community spending charged to the National Health Service (Servizio sanitario nazionale, SSN), with wide regional variation that leaves eight regions above the community ceiling and five comfortably within it.
Presenting the data, the Technical‑Scientific Director of AIFA (Direttore tecnico scientifico), Pierluigi Russo, notes that growth in direct‑purchase spending has slowed to 4.9% year‑on‑year at September 2025, compared with 9.1% at September 2024 and 15% at April 2024, but warns that the current level still raises sustainability concerns.
For regional payers and companies with significant hospital portfolios, the figures confirm that policy attention will continue to focus on direct‑purchase budgets, with further pressure likely on contract terms, managed‑entry agreements and product mix in high‑spend therapeutic classes.
Source: Agenzia italiana del farmaco
Link: Monitoraggio AIFA spesa farmaceutica gennaio-settembre 2025 (AIFA monitoring of pharmaceutical expenditure January–September 2025)
Date: 29 January 2026