OBJECTIVES: Since 2009, our country and its National Healthcare System are experiencing the effects of a deep economic crisis. The study was performed in a regional 560-bed public hospital. The aim is to investigate the impact of the economic crisis at the cost of the drugs administrated.

METHODS: The total cost of the drugs administered, the pharmaceutical cost per patient and per ATC category (J and L01) and the share of Originators and Orphan drugs for the years 2009 to 2016 were measured.

RESULTS: The cost of drugs dispensed during 2009 was 16,541,037€ (65% Originators), 793€/patient. During 2014 was 7,518,901€ (62% Originators), 393€/patient and in 2016 8,920,488€ (72% Originators), 478€/patient. The cost of Orphan drugs during 2009 was 203,479€ (1% of the total), in 2014 was 452,450€ (6% of the total) and in 2016 was 1,508,322€ (17% of the total; for elosulfase alfa, agalsidase beta, agalsidase alfa was 12% of the total). The cost of the Antiinfectives for systemic use decreased from 3,938,153€ (24% of the total) in 2009 to 1,612,503€ (18% of the total) in 2016. The cost of Antineoplastic agents decreased from 3,012,696€ in 2009 (18% of the total) to 1,878,968€ (21% of the total) in 2016. The number and the percentage of Antineoplastic’s Originators cost increased from 2009 (29 drugs, 74% respectively) to 2016 (63 drugs, 92% respectively).

CONCLUSIONS: The total cost of medications and per patient has declined significantly until 2014, with possible causes, the decrease in drug supply prices and a reduction in Originators’ use. Instead, there was an upward trend in the years 2014-2016, possible because of the increased use of expensive Orphan drugs and Antineoplastic Originators agents. A number of actions should be taken to decrease the budget: negotiating prices, frequent reassessment and monitoring of patients receiving Orphan drugs and Antineoplastic agents.