HHE HOPE 2019 - Page 6

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 6 HHE 2019 | hospitalhealthcare.com