CHART 5
Comparison between the variation in the total and public pharmaceutical expenditure:
Years 2006–2016
140%
Latvia
Estonia
120%
100%
Germany
80%
Lithuania
Belgium
60%
40%
Italy
20%
United Kingdom
-20% Luxembourg 0 0
Portugal
-20%
Finland
Ireland
France
Austria
Sweden Czech Republic
Denmark
The Netherlands
Greece
Switzerland
Slovak Republic
Poland
Spain 40%
Hungary
Slovenia
20%
60%
80%
100%
120%
-40%
Total pharmaceutical expenditure, PPP$ per capita: Variation 2006 - 2016
out-of-pocket payments, almost the entire amount
of inpatient health expenditure is financed
publicly. The total expenditure on inpatient care
(PPP$ per capita) in the EU follows, on average, a
growing positive trend. The exception is Greece,
where data available show that this indicator
varies negatively (–19%).
Pharmaceutical expenditure includes the
consumption of prescribed medicines, over-the-
counter and other medical non-durable goods.
One of the indicators taken into consideration for
2016 was the expenditure on pharmaceuticals
and other medical non-durable goods, as
percentage of current health expenditure. The
countries that registered the lowest rates of this
indicator are Denmark (7%), The Netherlands (8%),
Luxembourg (9%) and Sweden (10%) whereas the
highest ones were Greece (26%), Lithuania (27%),
Latvia (28%) and Hungary (29%).
More than
a third of
current health
expenditure
finances hospital
care
Between 2006 and 2016, the percentage of
pharmaceutical expenditure on total current
health expenditure has generally declined in all
of Europe. In 2016, the total pharmaceutical
expenditure was encompassed between 335 PPP$
and 369 PPP$ per capita in Denmark and Poland
respectively, and 777 PPP$ and 1080 PPP$ per
capita in Germany and Switzerland. At least half
of it was held by the public sector in all countries
except Denmark (44%), Latvia (35%) and Poland
(34%) and Lithuania (33%). The highest values in
2016 were in Germany (84%), Luxembourg (80%),
Ireland (77%), France (76%) and Slovakia (71%). In
2016 the pharmaceutical expenditure in PPP$ per
capita held by the public sector was encompassed
between 124 in Poland and 655 in Germany.
Chart 5 explores the relationship between the
trend of the total and the public pharmaceutical
expenditure between 2006 and 2016. In a group
of outlier countries (upper right part of the chart)
encompassing Estonia, Latvia and Lithuania, both
the public and the total spending varies
substantially. In Portugal, Luxembourg and
Greece, the same indicators varied negatively.
From 2006 and 2016 in the EU, the total
pharmaceutical expenditure decreased more than
the public pharmaceutical expenditure, which
decreased as well but at a slower pace. This
suggests that a progressively larger part of the
total pharmaceutical expenditure pertains to the
private sector. This shift may also indicate that
the ‘willingness to pay’ and the consumption of
pharmaceuticals by private owners are increasing.
Hospital capacity and delivery of care
In the last 15 years, healthcare reforms or other
initiatives implemented all over Europe aimed at
rationalising the use and provision of hospital
care, improving its quality and appropriateness,
and reducing its costs. The number of hospital
facilities decreased in most of the countries while
the number of hospital beds dropped off on
average. These reforms/initiatives also resulted in
a broad reduction of acute care admissions and
length of stay, as well as in improvements in the
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HHE 2019 | hospitalhealthcare.com