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Table 1 Basic characteristics of the healthcare system and pharmaceutical schemes in ABUEL study countries

From: The prevalence of self-reported underuse of medications due to cost for the elderly: results from seven European urban communities

Indicator Lithuania Sweden Germany Italy Spain Portugal Greece
Total health expenditure 2011 as % of GDP (PPP$ per capita)1 6.66 % 9.62 % 11.28 % 9.18 % 9.62 % 9.46 % 9.28 %
(1426 PPP$) (4158 PPP$) (4617 PPP$) (3040 PPP$) (3145 PPP$) (2400 PPP$) (2347 PPP$)
Total pharmaceutical expenditure as % of total health 20111 24.9 12.1 14.1 16.2 17.4 17.9 28.5
Public pharmaceutical expenditure as % of total pharmaceutical expenditure 20111 34.2 58.3 75.6 46.6 71.0 55.1 73.7
Predominant health care financing mechanism2 Social insurance Taxes (local) Social insurance Taxes (local) Taxes (local) Taxes (central) Social insurance
Reimbursment mechanism for prescribed medicines NHIF reimbursed 50–100 % of price of selected medicines3 The patient has to pay the full cost for prescribed drugs, up to SEK 1100 (€122), after which level the subsidy gradually increase up to a 100 %.4 For prescription-only drugs, pharmacists are now paid through a flat-rate payment of €8.35 plus a fixed margin of 3 %. The retail price contains an additional 19 % VAT.5 Only Class A medicines are partially reimbursed by the SSN and involve a modest co-payment that varies across regions.6 I.e. Veneto Region implies co-payment mechanism from €2 for each packet up to a maximum of €4 for each prescription.7 Medical prescriptions funded by the SNS are exempt from co-payment for pensioners and their beneficiaries. nonpensioners and their beneficiaries pay 40 % of the retail price.8 There are four groups of medications and reimbursment varies by these categories from 90 % for category A to 5 % for category D. Pensioners have additional reductions from 5 to 15 %.9 Insured citizens participate in covering the cost of pharmaceuticals with a co-payment rate set at 25 %. Patients with chronic conditions are exempted from co-payments, while pensioners on lower incomes who are beneficiaries of EKAS pay a co-payment of 10 %. The very poor are entitled to pharmaceuticals provided by public hospitals free of charge.9
  1. Surce:1 – Ref. 10;2 – Ref. 11;3–Ref. 12;4 – Ref. 13;5 – Ref. 14;6 – Ref. 15;7 - Ref. 16;8 - Ref 17,9 - Ref 18
  2. GDP Gross Domestic Product, PPP Purchasing Power Parity, NHIF National Health Insurance Fund (Lithuania), SSN Italy’s National Health Service, SNS Spanish national health system, EKAS Social Solidarity Benefit for low-income pensioners