With Legislative Decree No. 159 of October 1, 2007 (converted into Law No. 222/2007), programmed ceilings for pharmaceutical expenditure were introduced, along with a structured cost-recovery mechanism in case of overspending.

From that moment on, payback was no longer just an occasional corrective tool, but became an integral part of the framework for controlling healthcare expenditure: our in-depth analysis is available here (for its peculiarity, only in Italian).