Francisco Álvarez Academic, Chemistry and Pharmacy, Andrés Bello University, Viña del Mar campus In Chile, falling ill not only means facing a health condition but also bearing a heavy economic burden. This burden primarily falls on families. While the country allocates 10.

5% of its GDP to health spending—equivalent to about US$36. 9 billion in 2024 and comparable to OECD countries—this figure conceals a structural weakness: the way medications are financed. Currently, households finance about 62% of medication expenses, which represent around 15% of total health spending, equivalent to 1.

5% of GDP. The issue is not how much is spent, but how it is distributed. Public spending on medications accounts for only 0.

46% of GDP, far below out-of-pocket spending, which reaches 0. 95%. In practice, access to treatments depends on individuals' income levels, deepening inequities that a healthcare system with a universal vocation should not tolerate.

Additionally, there are significant territorial gaps: in 2024, annual spending per beneficiary ranged from $44,200 in Iq…

This reinforces a reactive model focused on treating diseases once they have already developed, rather than preventing them in a timely manner. Closing this gap requires addressing one of the main shortcomings of the system: the lack of coverage for outpatient medications. Advancing towards explicit insurance would help reduce out-of-pocket expenses and improve therapeutic adherence, especially for individuals with chronic illnesses.

In addition, it is crucial to strengthen tools that have already shown impact. The intermediation of CENABAST—which in 2024 accounted for nearly 80% of public purchases—should be expanded to also influence the general market and contribute to sustained price reductions. Furthermore, a coordinated national medication policy and progress in system interoperability, integrating clinical information, prescriptions, and dispensing, would enhance efficiency, control spending, and advance towards more equitable access.

Chile does not necessarily need to spend more on health, but rather to spend better. Because when a person has to choose between buying their medications or covering other basic needs, the system has already failed. And in Chile, unfortunately, that is not the exception but the rule.