OBJECTIVES: The 2008 global financial crisis hit Portugal strongly culminating in request financial assistance from European Union and International Monetary Fund on 17th May of 2011. In addition, Portuguese economy had already before 2008 a decreasing real growth rate of GDP, stagnant from early in the decade, and an increasing external deficit. Healthcare measures represented a key area within the assistance program. Specific targets were set for public spending in pharmaceuticals in order to align with EU average at 1.25 and 1.0 percent of GPD for 2012 and 2013, respectively. The aim of our study was to demonstrate that GDP targets was a political decision not supported by evidence, technically inaccurate, created a hurdle and equity asymmetries for patients access to medications, as well as jeopardized the future sustainability of Pharmaceutical sector.  METHODS: We analyzed health, pharmaceuticals and medicines public spending EU benchmark in real terms, GDP ratio and per capita. We also revise the System of Health Accounts methodology and conceptual framework of International Classification of Health Accounts. OECD definitions, sources and methods were also studied.  RESULTS: Despite the efforts to improve the comparability across countries through common and better information framework of greater relevance for policy concerns, we observed that such approach is not recommended. For a more comprehensive understanding of health spending in relation to GDP ratio, it should be considered together with health spending per capita. Portugal comparisons are an OECD example for this rational. Importantly, OECD measures of pharmaceutical spending exclude in-patient (hospital) spending. In addition, pharmaceuticals definition is broader than prescription medicines only.  CONCLUSIONS: Important political decisions were taken assuming pharmaceuticals and prescription medicines as the same concept. Here, we demonstrate that setting arbitrary benchmarks based on empirical observation of comparative EU countries is incorrect due to wide inconsistencies over pharmaceutical distribution.