recent years there has been a deep process of decentralization of responsibilities for pharmaceutical care. The different choices made by regional and, to a smaller extent, local governments are reflected in strong gaps in the levels of public pharmaceutical expenditure. The present article intends to analyse the variability of pharmaceutical expenditure of local health authorities. The objective is to show that this variability is only partially explained by differences in the characteristics of demand, in the structure of supply of health care and in the choices of pharmaceutical policy. A part of it could be due to an excessive and inefficient use of prescriptions and drugs. The identification and elimination of these inefficiencies could allow local health authorities to free financial resources for other health programmes. In this context, the econometric analysis will be used not only for previsional purposes but also for normative ones, in order to evaluate the efficacy of different measures for containing and rationalizing pharmaceutical care and to propose the adoption of specific prescribing budget mechanisms at a local level.