How much does your medication cost each month and how can you cut it?

Working out what you really spend on medication is the first step to paying only what you need, with the co-payment caps in force since May 2026.

What your medication costs each month depends on whether it is prescribed through the public health system, your income, and whether you are a pensioner or in work. With a public prescription you pay a percentage, often with a monthly cap; with a private prescription, over the counter or for pharmacy services you pay the full price.

In this article we explain how to work out what you really spend under the 2026 rules and what you can safely do to reduce it.

What does the amount you pay for your medicines depend on?

It depends mainly on three things: whether the medicine is funded and prescribed through the public health system, your income, and whether you are a pensioner or in work. With a public prescription you only pay a percentage of the price (the contribution or co-payment); with a private prescription or without a prescription you pay the full price.

• National Health System prescription: you pay your contribution percentage, with monthly caps in some cases.
• Private prescription: even if the medicine is publicly funded, you pay the full price because there is no public contribution.
• Over-the-counter or non-funded medicines: over-the-counter painkillers, supplements or parapharmacy products are paid in full.
• Pharmacy services: services such as preparing your medication in a personalised dosage system (SPD) are not part of the co-payment and the pharmacy sets the price.
• Civil service mutual societies (MUFACE, MUGEJU, ISFAS): they have their own system; MUFACE states that its members generally pay 30% of the price.

How much is the co-payment in 2026?

Since 14 May 2026, Royal Decree-law 11/2026 has applied, changing the brackets and monthly caps of the pharmaceutical co-payment. This is a summary of what the Official State Gazette (BOE) sets for public prescriptions:

Some medicines for long-term conditions are "reduced contribution" medicines: you pay 10% of their price up to a maximum of €4.98. There are also exempt groups, such as people receiving a non-contributory pension or the minimum living income, or pensioners receiving the minimum pension supplement. We explain it in detail in the new pharmaceutical co-payment: how much you pay and whether you are due a refund.

How do you work out how much you spend each month?

Make a list of everything you buy at the pharmacy in a normal month and add up what you actually pay, not the price on the pack. That way you will know where the money goes and whether you are close to your cap.

1. Note each medicine, how many packs you use per month and whether it is on a public prescription, a private one or over the counter.
2. Keep your pharmacy receipts for a month: they show what you paid for each pack.
3. Add up separately what you pay on public prescriptions (subject to a cap) and everything else (no cap).
4. Compare what you paid on public prescriptions with the cap for your bracket. If you exceed it, under the law your regional government refunds the difference at least every six months. Ask how this works in your region.
5. Check in your electronic prescription record or your region's health app that your contribution bracket is correct.

What can you do to spend less?

The most effective step is usually to review with your doctor and pharmacist what you take, how it is prescribed and whether everything is still needed. Small changes can add up over a year.

• Move what you can to public prescriptions: if a private specialist has prescribed a long-term treatment, ask your GP whether they can consider prescribing it through the public system.
• Ask about generics: the Spanish Ministry of Health explains that a generic (EFG) has the same active ingredient, in the same amount and form, and the same efficacy and safety; it usually costs less. If your tablet suddenly looks different, read why your tablet has been swapped for one with another name.
• Review your treatment: if you take many medicines, ask for a review. Sometimes there are duplicates or drugs that are no longer needed, and only your doctor can stop them.
• Be selective with over-the-counter products: ask your pharmacist before buying supplements or products you may not need.
• Avoid stockpiling: collecting only what you will use stops packs you have paid for from expiring.
• Check whether you are exempt: if your situation has changed (retirement, unemployment without benefit, minimum living income), check your bracket.

A practical example: Antonio and his monthly spending

Let us take the case of Antonio, 63, still working, with high blood pressure, type 2 diabetes and high cholesterol, and an income of around €30,000 a year. He takes four medicines on public prescription, another prescribed by a private cardiologist and a magnesium supplement he bought himself. He feels he spends "a lot" but does not know how much.

For a month he keeps his receipts and discovers that the privately prescribed medicine, which he pays for in full, is his biggest cost. His GP reviews the case and considers prescribing it on a public prescription, so he now pays his percentage and it counts towards his monthly cap. His pharmacist also confirms that the magnesium is of no benefit in his case and explains that two of his treatments can be dispensed as generics. Antonio now knows what he really spends and reviews it every few months.

How can IMA Health help?

Having your medication in order also helps you control spending: you know what you take, how much you have left and you avoid buying too much. With IMA Health, a specialised pharmacy prepares your medication by day and time of each dose, and IMA coordinates with the pharmacy, delivers to your home and provides personalised follow-up. It is a paid service on top of what you pay for your medicines, so ask about its terms before deciding.

Sources

• BOE: Royal Decree-law 11/2026 of 12 May on user contributions to pharmaceutical provision (in Spanish)
• Spanish Ministry of Health: Generic medicines, frequently asked questions (in Spanish)
• MUFACE: Prescription dispensing and member contribution (in Spanish)

This article is for information only and does not replace advice from your doctor or pharmacist.