People who use the Spanish public health system will now have to pay part of the costs of prostheses, diet products and even non-emergency medical transportation, according to a decree published on Tuesday.

These products and activities will henceforth be considered "ancillary services" and therefore subject to part-payment by the user.  The percentage of user input "will be governed by the same rules governing pharmaceutical services".

Under the new rule, "the user input is proportional to the level of income, that will be updated annually." Thus, those with an income of more than 100,000 euros will pay 60% of the price of medicines, going down to 50% for those on incomes between 18,000 and 100,000 euros, and 40% for people whose income is less than 18,000 euros.

The government is also preparing a plan to combat "fraudulent use" of the public healthcare system by non-resident foreigners, which will save about 1,500 million euros.

The reform also provides for the creation of a Centralized Procurement Platform for autonomous communities to jointly purchase hospital drugs and medical technology, as is done with the flu vaccine, which will generate savings of between 1 and 1.5 billion euros.