OBJECTIVES: According to the OECD, spending on pharmaceuticals in Slovakia constitutes a higher share of health expenditure (24.4% compared to the OECD average of 15.1% and 15.2% in Czechia in 2019). Without detailed insight, however, such a comparison can be misleading. The aim of the study is to provide a detailed breakdown of drug expenditure in both countries.

METHODS: We analysed detailed bottom-up structure of drug expenditure according to drug spending patterns in 2019 (latest complete statistics) – prescription drugs for outpatient care and drugs used in specialised clinical centers. The results were expressed in nominal values and as expenditure per capita in official reimbursed prices. The primary data sources were the national statistics (NCZI in Slovakia, SUKL in Czechia) and insurance fund statistics.

RESULTS: In 2019 expenditure on drugs per capita in Czechia and Slovakia is comparable in general – €264 in Czechia and €239 in Slovakia and also in both main categories - €175 in Czechia and €170 in Slovakia for outpatient prescription drugs and €90 in Czechia and €69 in Slovakia for drugs in specialized centers. The total expenditure on medicines in Czechia is roughly double compared to Slovakia (€2.8 mil. in Czechia vs. €1.3 mil. in Slovakia), which corresponds to the size of the population. The different share of expenditure on medicines is due to total public expenditure on health care, which in Czechia is almost three times higher than in Slovakia (€14.4 mil in Czechia vs. €5.2 mil in Slovakia). We have identified several methodological shortcomings, which we present as suggestions for improving future statistics.

CONCLUSIONS: Our analysis shows that the drug expenditure according to specific categories expressed per capita is comparable between Czechia and Slovakia. However, we find a need to adjust the reporting methodology about pharmaceutical expenditure which will allow more robust future comparison between countries.