Austria: Pharmaceuticals - Nat'l Health Systems

Expenditure On Retail Pharmaceuticals Per Capita, 2017 (USD$ PPP)
Prescribed Medicines: $494
Over-The-Counter Medicines: $140
Medical Non-Durable: $12
Total: $646

Source: OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.
https://www.oecd.org/health/health-systems/health-at-a-glance-19991312.htm

Expenditure On Retail Pharmaceuticals By Type Of Financing, 2017 (%)
Government/Compulsory Plans: 68%
Voluntary Health Insurance Plans: 1%
Out-Of-Pocket: 31%
Other: 0%

Source: OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.
https://www.oecd.org/health/health-systems/health-at-a-glance-19991312.htm

“All insured individuals have free access to medicines included in the positive list of SHI [Social Health Insurance] reimbursable pharmaceuticals for use in the ambulatory (extramural) care sector, if prescribed by a physician. Physicians are allowed to freely prescribe medications listed in the green section of the positive list, which includes also OTC medicines. Other medications in the list (in the yellow section) require permission by a physician of the SHI fund or documentation to allow retrospective justification (Hofmarcher and Quentin, 2013) (see section 2.8.4).

“In 2018, the prescription fee per prescribed item amounted to €6.00 (HVB, 2018b) with all costs exceeding this amount covered by the SHI funds. For medicines with a gross reimbursement price below the prescription fee individuals pay the full price. No cost-sharing applies to pharmaceuticals provided in inpatient settings.

“Certain population groups (e.g. individuals with infectious disease, pensioners with a compensatory allowance) and individuals with a household income below certain thresholds are exempt from prescription fees (BMGF, 2017ar) (see section 3.4.1). The proportion of insured individuals exempt from prescription fees varies significantly across SHI funds. In 2016, the share of insured exempted from prescription fees was lowest in the regional SHI fund of Burgenland (2%) and highest in the regional SHI fund of Vienna (28%) (Wilbacher, 2018). Since 2008 a prescription fee cap of 2% of an individual’s annual net income has been in place, in particular to alleviate the burden of prescription costs for chronically ill people (BMGF, 2017ar). However, patients have to pay a minimum of €222 (for 37 prescriptions) before the 2% threshold applies. Despite these exemptions, prescription fees accounted for 6.4% of total out-of-pocket expenditures in Austria in 2015 (see Table 3.7). Patients admitted for inpatient treatment are not required to pay any additional costs for prescriptions.”

Source: Bachner F, Bobek J, Habimana K, Ladurner J, Lepuschütz L, Ostermann H, Rainer L, Schmidt A E, Zuba M, Quentin W, Winkelmann J. Austria: Health system review. Health Systems in Transition, 2018; 20(3): 1 – 256.
http://www.euro.who.int/en/about-us/partners/observatory/publications/health-system-reviews-hits
http://www.euro.who.int/en/about-us/partners/observatory/publications/health-system-reviews-hits/full-list-of-country-hits

“Medication consumption is measured in packets. In 2015, in total 240.7 million packages of prescribed and non-prescribed medicines were sold, of which about 90% (217.9 million packages) were dispensed in the ambulatory sector (Pharmig, 2017). About 49% of the packages sold (119 million) were financed by SHI funds, corresponding to 14 packages per insured person.

“Total expenditure on prescribed and non-prescribed medicines in the ambulatory sector accounted for €4 300 million in 2015, i.e. 12.4% of total current health expenditure and €504 per person, with 69.7% financed from public sources. While per capita spending on pharmaceuticals is above the OECD average, the share of pharmaceutical expenditure of current health expenditure is below the OECD-30 average of 15.7% (see section 7.2.1) (OECD, 2017d).

“The generics share of pharmaceutical sales is relatively low with 32.5% of the ambulatory reimbursement market in volume and 14.3% in value in 2015, partially owed to the fact that neither INN (International Nonproprietary Name) prescribing nor generic substitution is allowed. In the inpatient sector availability of data on prices and the generics share is limited, posing challenges for efforts towards more cost-efficiency (Panteli D et al., 2016; Zimmermann and Rainer, 2018). On a more positive note, the frequency of prescribed antibiotics in Austria (13.9 defined daily doses per 1 000 population per day) is below the OECD-30 average (21 defined daily doses per day) in 2016 (OECD, 2017b).”

“Sickness funds finance covered outpatient medicines dispensed by community pharmacies and state governments finance medicines used in and dispensed by hospitals.

“The government does not set a budget for pharmaceutical spending at national or subnational level as part of the budgetary process. However,since 2013, the SSFs and the federal and state governments agree on a cap on annual growth in SSF public health expenditure in national planning agreements. These are based on the federal constitution and referred to as target-based governance agreements (“Zielsteuerungsverträge”). The national cap is disaggregated at the level of each SSF and state government, but not by function of care.”

Source: OECD (2019), Pharmaceutical Expenditure Tracking, Budgeting and Forecasting in 23 OECD and EU countries. Country Notes.
https://www.oecd.org/health/health-systems/improving-forecasting-of-pharmaceutical-spending.htm

“While target-based governance agreements effectively set a cap on total health expenditure by SSFs [Statutory Sickness Funds] and state governments, no cap is defined specifically for pharmaceutical expenditure.”

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 several other nations.

Page last updated Dec. 29, 2020 by Doug McVay, Editor.