The data is revealed in a study that estimates 1,577 preventable annual deaths with greater equity in access to medicines.
The first edition of the Medicines Access Equity Index, released by the Portuguese Association of Medicines for Equity in Health (EQUALMED), points to an association between inequalities in access to medicines and their impacts on health.
Access at a moderate level
According to the study, between 2022 and 2025, the level of equity in access to medicines for the Portuguese was moderate (52%), but lower than in Spain, Italy, France and Belgium, benchmark countries in drug pricing.
“The result of a series of variables that were studied indicates that (…) 5.2 out of every 10 Portuguese people effectively have equity in access to medication,” the president of EQUALMED, João Paulo Nascimento, told the Lusa news agency, adding that “a significant number of people” have difficulties accessing medication.
Based on statistical correlations, the study reveals that Portugal has about 4 fewer years of quality of life than France.
Cause of death
It also estimates that 1,577 deaths from treatable pathologies could have been avoided in the period under analysis if Portugal had reached a level of equity similar to that of France.
“A 5% increase in the level of equity and access to medication could be associated with a 3% reduction in treatable mortality per year,” the association emphasises.
Economic level
At the economic level, Portugal has the highest expenditure on medication relative to average citizen income, based on per capita expenditure and average salary.
Each Portuguese citizen spends an average of €148.30 per year on medication, compared to an average annual salary of €20,451.
In France, the country where citizens spend the least on medication, the average expenditure is €72.70, while the average salary is €44,904.
According to the index conducted by the consulting firm IQVIA, Portugal and Italy have the highest percentage of the population reporting difficulties affording medication costs, at 16.1% and 17.4%, respectively, compared to 4% in France.
National inequalities
The analysis also reveals significant regional inequalities of up to 10%, with the Alentejo region showing the worst results, followed by the Oeste and Vale do Tejo regions, while the North, Greater Lisbon, and the Setúbal Peninsula register the highest levels.
“Despite these differences, a progressive decrease in equity in access to medication is observed between 2023 and 2025,” it emphasises.
According to the study, socioeconomic factors explain only 23% of the variations in this index, with the remainder linked to factors specific to each country, such as budgetary, regulatory, and organisational issues within health systems.
Lack of healthcare professionals
Portugal still appears among the countries with the lowest number of active healthcare professionals per 100,000 inhabitants, hindering access to therapeutic prescriptions, a crucial step in obtaining medication.
João Paulo Nascimento stressed that the index “is not intended to point the finger at anyone,” but to create “a working tool that allows for a discussion about the future of healthcare in Portugal, because it is a fundamental sector, a strategic sector as well, from the point of view of national sovereignty.”
Investing in drug policy
To improve access to medication, the official cited recommendations from the study, namely, greater investment in drug policy.
“We need to approach the ‘per capita’ investment of these benchmark countries, because this translates immediately into less spending for the healthcare system and greater productivity for the country,” he argued. João Paulo Nascimento explained that the study arose from the need to measure equity in access to medicines in Portugal: “We represent the generic, biosimilar and value-added drug industry and, over the years, we have contributed significantly to the balance of equity in health.”
“However, in recent years, and also by reference to the work that has been published internationally, we felt the need to create an indicator, an index of equity in access to medicines,” he added.
The index assesses the economic capacity of families, the sustainability of the health system, the regulation and approval of medicines, and the number of health professionals and institutions per 100,000 inhabitants in Portugal.