BRUSSELS, Dec 4 (APM) - Pressure to contain spending on medicines in Europe will be reinforced by the confirmation from the the European Commission that, despite recent cutbacks, pharmaceuticals remain a significant component in healthcare costs across EU member states.
Just days after EU health ministers signed off on conclusions noting concerns over the high price of medicines (APMMA 40642), the commission's annual review of healthcare, 'Health at a glance 2014', points out that spending on pharmaceuticals accounts for almost a fifth of all health expenditure, exceed only by inpatient and outpatient care.
Based on the latest aggregate figures for the EU, which cover 2012, it says the total pharmaceutical bill across the EU approached 200 billion euros in 2012.
The detailed figures show wide divergences from country to country. Belgium has by far the highest per capita spend at 550 euros, followed at a distance by Germany (501 euros) and Ireland (500 euros). The EU average is 350 euros per capita.
At the other end of the scale, Denmark, Latvia and Romania spent less than 200 euros on a per capita basis.
Pharmaceutical spending accounted for 1.5% of economic output (GDP) on average across EU member states with a little under two thirds financed publicly and the rest from private sources.
But again, the national figures vary widely. Pharmaceutical spending as a share of GDP ranged from less than 1% in Luxembourg and Denmark to over 2% in Hungary, Greece and Slovakia.
And public funding of pharmaceuticals ranged from 0.3% of GDP in Denmark and Cyprus to as much as 1.5% of GDP in Greece.
These wide variations are also likely to fuel the discussions now underway in the EU on how to improve health system performance - one of the priorities that the new EU health commissioner, Vytenis Andriukaitis, has said he is determined to push through (APMMA 39976).
The review records the impact of efforts to contain pharmaceutical spending - which have been intensified by the economic crisis.
In most of the first decade of this century, the average growth of pharmaceutical expenditure per capita was 3.7% in real terms, but fell by more than 2% per year in real terms between 2009 and 2012.
In three quarters of EU countries, pharmaceutical spending has dropped in real terms since 2009, and in all EU member states, the average growth rates between 2009 and 2012 were below those of the pre-crisis period.
The reduction was particularly steep in the countries hit hardest by the recession. In Greece, pharmaceutical spending per capita has decreased by more than 12% a year since 2009, following high growth rates in the preceding years.
Annual spending also fell in Portugal (-6.1%), Spain (-5.2%), Italy (-3.9%) and Cyprus (-3.5%) in 2009-12.
Countries that were less severely affected by the financial crisis also saw falls in spending. Annual decreases were registered even in Switzerland (-1.0%) and Germany (-0.4%).
But while spending has been contained, volume has been rising, says the Commission. "The overall quantities of pharmaceuticals consumed have often continued to increase, partly driven by growing demand for drugs to treat ageing-related and chronic diseases."
Prescriptions for antihypertensives nearly doubled on average in EU countries between 2000 and 2012, with per capita consumption highest in Germany, Hungary and the Czech Republic.
At the same time, the use of cholesterol-lowering drugs has more than tripled across EU countries, driven both by increased obesity and wider screening.
The UK, Slovakia and Belgium had the highest consumption in 2012, at least 30% higher than the EU average. The commission ascribes the uneven consumption figure in part to differences in clinical guidelines for the control of cholesterol.
The use of drugs against diabetes nearly doubled on average, also linked to increases in the prevalence of obesity. Finland, Germany and the UK were the top consumers.
The consumption of antidepressants has also nearly doubled in EU countries since 2000, again with wide variations, which the commission again ascribes to variations in national guidelines for the treatment of depression and varying prescribing behaviours among general practitioners and psychiatrists.
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