A DECADE OF GROWTH IN PUBLIC AND PRIVATE PHARMACEUTICAL EXPENDITURES: THE CASE OF BELGIUM 1990-1999

Abstract

Objective: To make a systematic, transparent, internationally comparable description of trends (1990-1999) in total, public and private (co-payment + out-of-pocket) spending on pharmaceuticals in Belgium.Setting: Belgium, a western European country, with a Bismarck-type universal coverage healthcare systemNature of the study: Descriptive analysis of time-seriesMethods: Collaborative data gathering effort between academic and private research institutes and IMS health.Results: Mean annual growth rate was 3.9% for total, 5.3% for public, and 2.0% for private drug expenditures (expressed in constant 1999 EUR). The ratio of public to private spending shifted from 53.4% to 60.3%. Of the private spending, one third was co-payment for reimbursed medication and two thirds was out-of-pocket payment for non-reimbursed medication.Conclusion: Co-operation between several data gathering constituencies within one country was necessary to achieve completeness and detail in data collection on out-of-pocket payments for non-reimbursed medicines, and hence in total drug expenditures. Discrepancies were found between the estimate of the public/private mix and OECD health data 2000 for public drug spending.