OBJECTIVES: As the aging population continues to grow, ensuring adequate access to essential medications has become increasingly important for maintaining the health and well-being of older adults. Chronic underinvestment can challenge public health systems, weakening their ability to address basic healthcare needs of the population. The objective of this study was to evaluate the impact of public health expenditure on unmet pharmaceutical needs among older European adults

METHODS: We utilized data from a sample of 42,780 individuals aged 50 years and above, representing 26 countries that participated in wave 8 (2019/2020) of the Survey on Health, Ageing, and Retirement in Europe. Multiple probit regression analyses were used to estimate the independent effect of public health expenditure on the probability of unmet pharmaceutical needs

RESULTS: The prevalence of unmet pharmaceutical needs rose in most countries between 2004 and 2020. Romania had the highest frequency in 2020 at 11.6%, followed by Slovakia (6.3%) and Latvia (4.1%). Increased public health expenditure had a significant impact on reducing the likelihood of unmet pharmaceutical needs. The average marginal effect varied notably across European countries, with higher rates observed in nations characterized by high unmet pharmaceutical needs and low public health expenditure. Other important risk factors for unmet pharmaceutical needs included younger age, unemployment, lower income, and poorer health status.

CONCLUSIONS: Significant and sustained investments in public health through increased public health expenditure would have a positive impact on access to pharmaceutical care and, in turn, lead to improvements in overall health outcomes.