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Abstract
Since the beginning of the second millennium, reimbursable drugs have been classied into two classes in Italy: (1) class A, which includes essential drugs and drugs for chronic diseases; and (2) class H, for drugs dispensed only in hospital and thus unavailable in community pharmacies. Starting from 2008, this classication relates closely to pharmaceutical expenditure control since the two classes are capped under different ceilings subject to pay-backs in case of overspending. Trying to interpret class H meaningfully, since there is no technical denition, we might guess that the drugs included should be limited by the hospital setting, typically the routes of administration (e.g. intravenous), which can seldom be delivered in the community, and/or for patient safety reasons during their administration. These criteria should reect the indications in the European Public Assessment Reports (EPARs) for drugs approved through the centralised procedure [1].