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Sweden: Pharmaceuticals

Sweden: Pharmaceuticals

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Expenditure On Retail Pharmaceuticals Per Capita, 2019 (US$ PPP)
Prescribed Medicines: $378
Over-The-Counter Medicines: $116
Total: $494

Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.


Expenditure On Retail Pharmaceuticals By Type Of Financing, 2019 (%)
Government/Compulsory Plans: 55%
Voluntary Health Insurance Plans: 0%
Out-Of-Pocket: 45%
Other: 0%

Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.


“There are approximately 9000 registered pharmaceuticals and about 1200 active substances in Sweden (National Corporation of Swedish Pharmacies, 2009). The total pharmacy sales of medicines amounted to SEK 35.7 billion (€4 billion) in 2009, of which about two-thirds were prescription drugs. Compared to 2008, there was an increase in sales of prescription drugs by 1% (Research-based Pharmaceutical Industry, 2010). Since October 2002, the TLV has had the responsibility of deciding whether a prescription drug or specific product should be subsidized and included in the reimbursement scheme. The TLV makes its decisions primarily based on the cost–effectiveness of various products. Moreover, together with the introduction of the TLV, generic substitution was introduced, implying that any prescribed drug, which qualifies for a subsidy, has to be replaced by the cheapest comparable generic alternative available at the pharmacy. It is the MPA that decides which drugs are interchangeable. In 2009, the sales of generics corresponded to 14.4% of the total sales value of pharmaceuticals in Sweden. This is equal to almost 45% of the total sales volume in terms of defined daily doses (Research-based Pharmaceutical Industry, 2010).”

Source: Anell A, Glenngård AH, Merkur S. Sweden: Health system review. Health Systems in Transition, 2012, 14(5):1–159.


“There are about 1200 pharmacies throughout the country, distributing prescription and non-prescription drugs to the population and to hospitals and other health services. Until 2009, all pharmaceuticals in Sweden were distributed and sold to the general public by the state-owned National Corporation of Swedish Pharmacies (Apoteket AB). The Swedish pharmacy market was recently re-regulated, allowing new owners to operate pharmacies from 2009 and allowing the sale of OTC drugs outside pharmacies, for example, in grocery stores. At the same time, about half of the state-owned pharmacies operated by the National Corporation of Swedish Pharmacies were sold. The number of pharmacies increased by about 20% following the reform (Swedish Competition Authority, 2010a). In 2011, there were 13 pharmacy operators in Sweden, compared to the previous monopoly situation with one state-owned pharmacy.”

Source: Anell A, Glenngård AH, Merkur S. Sweden: Health system review. Health Systems in Transition, 2012, 14(5):1–159.


“Sweden spent a smaller proportion of health expenditure on outpatient pharmaceuticals and medical devices (13%) compared to the EU average (18%). The relatively low spending on pharmaceuticals dispensed outside of hospitals can be attributed in part to lower prices for medicines and relatively high use of generics. Spending on prevention accounted for 3.3% of all health spending – a share higher than the 2.9% EU average.”

Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.


“A number of initiatives have been pursued at the national and regional level to promote a more appropriate use of pharmaceuticals and greater use of generics, as well as to reduce their prices.

“Generic substitution is mandatory. In addition, Sweden uses an approach of the ‘preferred product of the month’ and established a system of mandatory substitution for the lowest priced generic alternative for reimbursement, regardless of what the doctor has indicated on the prescription (WHO Regional Office for Europe, 2018).”

Source: OECD/European Observatory on Health Systems and Policies (2019), Sweden: Country Health Profile 2019, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.


“To promote more appropriate prescribing, a ‘Wise List’ (Kloka Listan in Swedish) has been developed and expanded in the Stockholm metropolitan region since 2000 for use throughout the region. The prescribing recommendations are developed by a group of experts including physicians, clinical pharmacologists and pharmacists. The Wise List now recommends 200 medicines for treating common diseases in primary and hospital care and an additional 100 medicines for specialised care (WHO Regional Office for Europe, 2018).

“A 2018 government investigation suggested several improvements in the governance, financing and pricing of medications to safeguard patients’ opportunities to benefit from progress in pharmaceutical treatments. The Swedish, Finnish and Norwegian health technology assessment (HTA) authorities also agreed in 2018 to strengthen their collaboration in assessing new pharmaceutical products under the FINOSE initiative (Box 4).”

Source: OECD/European Observatory on Health Systems and Policies (2019), Sweden: Country Health Profile 2019, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.


Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.


Page last updated August 19, 2022 by Doug McVay, Editor.

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