Germans spend more on medicine than most of Europe

80% of Germans were prescribed generic drugs in 2013. [onnola/Flickr]

Expenditure on medicinal drugs in Germany is higher than in most other European countries, according to the OECD. EURACTIV Germany reports.

In 2013, when corrected for purchasing power, Germans spent an average of €623.687 each on medicine, 30% higher than the OECD average. These were the findings of the latest report compiled by the Organisation for Economic Co-operation and Development (OECD), entitled “Health at a glance”. The report found that in Europe, only Greece tops them in terms of expenditure.

In the last year, German spending on medicine rose by around 7% after a period of stagnation (2009-2013). By comparison, overall per-capita health spending increased in that period by 2% a year (adjusted for inflation) and initial estimates for this year put the figure at 2.5%.

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Spending on medicine has risen so much due in part to increased spending on expensive drugs, such as Hepatitis C supplements. Additionally, the discount applied by producers of patented drugs and offered to health insurance schemes was reduced at the beginning of 2014.

In general, Germans take a lot of medicine. For example, their intake of antihypertensive drugs is higher than in all other OECD countries. The figure is three times higher than it is in Austria. Antidiabetics are prescribed much more frequently than the OECD average too. Between 2000 and 2013, consumption has almost doubled. The increase in diabetes is closely linked to an aging population and the more widespread prevalence of obesity and poor diet.

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The consumption of antidepressants has grown significantly, as well. Although its number of daily doses is 53 per 1,000 Germans, slightly below the developed countries’ average of 58, this figure has grown from 21 doses back in 2000. At the same time, national authorities are reporting more sick days being taken as a result of depression.

However, it is unclear whether psychological disorders are diagnosed more frequently because they are more widespread now or whether it is because it is more socially acceptable to talk about them than previously.

Readily available medicines

In June of this year, a study already found that German expenditure on medicines is higher than the European average. However, it also found that new drugs are made available quicker in Germany than anywhere else.

On behalf of the National Association of Statutory Health Insurance Funds (GKV), Reinhard Busse of the Technical University of Berlin undertook a systematic comparison of the medicine supply in Germany and 15 other European health systems. Busse came to the conclusion that nowhere are new medicines made available as quickly and extensively as they are in Germany.

Generic drugs pushed

In an attempt to keep costs under control, Germany has taken a number of measures, including promoting the use of cheaper generic medicines. In 2000, 47% of people were prescribed generic drugs, this figure rose to 80% in 2013, with the OECD average currently at 48%. Overall, OECD pharmaceutical spending in 2013 amounted to $800 billion. If one were to include medication used in hospitals as well, this would total 20% of total health expenditure. 

The majority of countries in the European Union set pharmaceutical prices according to a legally fixed price. Until 2012, Germany was among the three countries in which there was no price regulation for medications.

Since the Re-organisation Law for the Pharmaceutical Market (AMNOG) took effect in 2012, a new pricing rule applies for new drugs.

According to the measure, the GKV association negotiates with pharmaceutical manufacturers over discounts on the list price of new medications, which the company determines in advance.

Within the two months before negotiations take place, the price set by the manufacturer applies.

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