Pharmaceutical assistance: Direct distribution of medicines

Direct distribution is understood as the dispensing, through health facilities, of medicines to patients for administration at home. While all medicines, with the exception of those for hospital use only, are distributed (sold) in local pharmacies, the medicines of the PHT (Hospital-Territory Handbook) can be purchased by health companies on condition of favor and be distributed directly by public health centers or possibly distributed by pharmacies, which agree with the Province a compensation for the service (distribution on behalf). Also drugs distributed within residential facilities, such as nursing homes, prison.. , are considered drugs in direct distribution.
In 2015, not considering patients assisted in residential facilities, 5.7% of the population of about 30,000 people, received at least one drug directly from the health care facility for care at home. The most distributed drugs, in terms of packaging, concern those for the treatment of diseases of the gastrointestinal system / metabolism followed by those for the central nervous system. Within residential facilities, on the other hand, the distribution of drugs for the central nervous system (over 40% of the total packaging distributed) is significantly predominant.
The active ingredient with the highest expenditure in direct distribution registered in 2015 corresponds to the drug Sofosbuvir (in Italy marketed as Sovaldi) for the treatment of hepatitis C, which with 4.1 million euros of purchase cost of the drug represents 7.9% of the total expenditure. Total expenditure on medicines delivered through public facilities (hospitals, company services) amounted to EUR 48.8 million. To these must be added a further € 1.0 million of the service cost for the distribution of a part of these drugs through pharmacies in the territory: about 122,000 packages distributed directly by pharmacies on behalf of the Health Authority. The cost of purchasing drugs distributed within residential facilities is over 2.7 million euros (more than half of the expenditure concerns the distribution of drugs for patients in nursing homes and a third for patients followed in psychiatric centers).