The pharmaceutical industry is rich with seniors

The elders They are an economic engine also from the point of the medicine industry, since it is the age group that most drugs consumed. And the high life expectancy achieved in recent years has to do, in part, with a key advance for humanity: the chronicification of many diseases –hypertension, diabetes, osteoarthritis, heart disease…–. A success that has been achieved thanks to the development and mass production of medicines. This factor, added to the use of vaccinesto improvements in hygienic conditions and in the habits of life or the development of social protection systemsexplains why this average currently exceeds 80 years in OECD countries and reaches 84 in Spain.

Specifically, it is estimated that more than 40% of the elderly have two or more chronic diseases and this means that about three out of 10 people People over 65 years of age take more than five active ingredients on a recurring basis. A percentage that increases in the 85 to 94 age group, up to 44.7%, according to the report Use of chronic drugs in polymedicated people aged 65 and over and its relationship with morbiditypublished in January by the Ministry of Health –you can read it here– and prepared based on data from Primary Care.

Thus, the seniors have consolidated themselves as the main clients of the medicine industry, both privately and through products financed by the administration. And, as society ages, this proportion has continued to increase. Two decades ago it was estimated that around 70% of the pharmaceutical expenditure of the National Health System –13,855,066,160 euros, in 2025– was performed by the elders. A proportion that will increasingly be higher – people over 65 years of age are already more than 20% of the population – and that translates into estimates such as, according to AIREF calculationsthe percentage of GDP allocated to Health could go from 6% to exceed 8% in 2050 due to this demographic change.

In that same sense, a report from the Foundation for Applied Economics Studies (FEDEA) on the National Transfer Accounts (NTA) for Spain in 2022 provides revealing data. The study confirms that the consumption of health services and health interventions presents a turning point around the age of 55. From this age, spending begins a pronounced growth that does not stop. Individuals over 60 years of age fall into what is called a “life cycle deficit”since their labor income falls substantially while their consumption needs, driven by healthcare and pharmacy, remain the same or grow. In fact, from the age of 65, public benefits – healthcare and pensions – They more than double the amount obtained by young people.

And, despite the strong public coverage of the National Health System, an important part of the spending is made by citizens out of their own pockets. According to a recent survey by the Organization of Consumers and Users (OCU) carried out on 1,278 households –not specified by age–, Each Spanish family spent an average of 1,351 euros in the last year on health products and services. If the cost of private health insurance is excluded, the average out-of-pocket expenditure is at 994 euros per year. And within this domestic expense, medicines are the most common item. Families spend an average of 222 euros annually on prescription drugs – purchased by 90% of those surveyed – and 175 euros on over-the-counter medications. At the global system level, in 2024, funded prescription pharmaceutical spending reached 13,865 million euros, which represents an increase of 4.9% compared to the previous year. This translates into a public pharmaceutical expenditure of 285.2 euros per year per person.

The rationalization of health spending

To address the growing demographic weight of the elderly, which translates into more spending on drugs, from the Ministry of Health a reform of the Medicine Law. In one’s own draft law, Pending approval in the second round by the Council of Ministers and the parliamentary process, it is implied that one of the objectives of this norm is to seek measures to face this new reality.

The document explains that the pharmacist is the main health expense from the age of 55 and that its weight increases with age, exceeding the 60% of total spending from 75 years of age. Likewise, it is said that greater longevity is associated with a higher rate of chronic disease and a greater consumption of resources.

In this way, the reform seeks to adapt the system to “demographic challenges” addressing the medicine cycle in a “holistic” way to ensure that the health needs of the population are met in a sustainable way. The preliminary project details that the National Health System (SNS) “is the main client of the pharmaceutical industry in Spain and invests a growing amount of euros annually in it –29,690 million euros in 2023, with an average increase of 1,200 million more each year since 2014–.

To guarantee the viability of the system against this volume of expenditure, the draft lawpending approval in the second round by the Council of Ministers, foresees a budgetary impact that will mean a total net saving of between 1,372.01 and 1,477.01 million euros.

This economic adjustment is mainly based on savings of 800 million euros derived from promoting competition through greater use of generic and biosimilar medicines, as well as another estimate of 500 million euros, as a result of the application of rational use measures and regional programs to improve the prescription of medicines, to avoid inappropriate polypharmacy, which, as explained to 65AND MORE from the Ministry of Health itself, is produced by the cascade prescription; the lack of periodic review; the toself-medication and use of alternative remedies; the Ffragmentation of attention, that is, the little coordination between specialists; and the fhigh longitudinality –the same professionals who care for the person– in Primary Care. This objective, that of ending the inappropriate polypharmacyis shared by all actors, including the pharmaceutical industry itself, as the employers’ association assured this same newspaper. Farmaindustriawhere they bet on “the importance of the proper use of medications.”

Other key points of the draft are:

• Price regulation: establishes mechanisms to control drug prices, preventing them from being excessively high and guaranteeing their accessibility to the population.
• Generic promotion: encourages the use of generic medications, which are usually cheaper and have the same effectiveness as brand-name drugs, which helps reduce costs.
• Education and training: includes training programs for health professionals and patients, in order to improve knowledge about the proper use of medications and avoid irresponsible self-medication.
• Advertising control: regulates the advertising of medicines to avoid misleading messages that could lead to inappropriate use.
• Pharmacovigilance: implements tracking and monitoring systems for the side effects of medications, ensuring that potential health risks are detected and managed.
• Equitable access: seeks to ensure that all people, regardless of their economic situation, have access to essential medicines.

The pharmaceutical market, in data

As the report explains The value of medicine from a social perspectiveprepared by the Health Economics Research Center Weber with the support of Farmaindustria, in Spain it is estimated that there are currently almost 350 pharmaceutical manufacturing companieswith a production valued at more than 15,000 million euros –24% of all high technology in the country–.

Furthermore, it is a growing sector, as demonstrated by the figures at European level, explained on the website of Farmaindustria: In 2015, the sector as a whole generated products worth more than 238 billion euros, which represents an increase of 90% compared to 2000.

It should be noted that according to the Retail Pharmaceutical Market Trend Report prepared by the consulting firm IQVIA, with data as of November 2025, the pharmaceutical market in Spain –including pharmacy and parapharmacy, physical and online– reached 27,499 million euros in the accumulated of the last twelve months (MAT). Of this figure, 20,408 million euros They correspond exclusively to the sale of medicines. The report also pays special attention to the drugs that are driving the growth of this market, these are: prantidiabetic products (+3.1%), pnon-dietary anti-obesity products (+ 0.9%), toantithrombotic agents (+ 0.5%), topeople that act on the renin-angiotensin system (+ 0.2%), pnon-antiobesity psychoanaleptics (+ 0.2%), topainkillers (+ 0.2%), purological products (+ 0.2%), iimmunosuppressants (+ 0.1%), miorrelaxants (+ 0.1%) alreadyantiepileptics (+ 0.1%).

On the other hand, considering the billing, with data of Health Market Research, As of September 2023, the top five companies drug manufacturers It was made up of: Cinfa, Boehringer Ingelheim, Norman, Novo Nordisk and Viatris.

What medications do the elderly consume?

According to the report Use of chronic drugs in polymedicated people aged 65 and over and its relationship with morbidity, The medications most consumed by older people who take more than five pills a day – those considered polypharmacy – are:

• Anti-peptic ulcer drugs: the absolute leaders, consumed by more than 70% of polymedicated people in all age groups from 65 years of age.
• ACEI / ARA-II (antihypertensives): its consumption is located between 55% and 70%depending on the decade of age.
• Lipid modifiers: They are used by more than 50% of polymedicated patients, although their use falls substantially upon reaching 95 years of age.
• Diuretics: This group reaches a prevalence of consumption greater than 50% only after the age of 95.

Along with these great leaders, there is a second echelon with a very high use – above 40% of polypharmacy – that varies strongly depending on the stage of aging:

• The oral antidiabetics They stand out especially between 65 and 74 years old.
• The vitamin D experiences a great rebound after the age of 85.
• The antiplatelets and analgesics use exceeds 40% in the population aged 95 years or older.
• At around 30% of chronic consumption, the antidepressants and anxiolytics and hypnotics.