Spending on drugs totalled HRK 7.6 billion in 2019, according to unofficial information, while Croatian Health Insurance Fund (HZZO) outlays for drugs, according to an annual report, amounted to HRK 5.6 billion, the Institute of Public Finance says in a study on drug spending.

HZZO outlays for drugs rose from 19% of its total expenditures in 2014 to 24% in 2019 and a big increase in outlays was recorded for highly expensive drugs. In 2018, spending on drugs totalled HRK 6.6 billion, while in 2017 it amounted to HRK 6.1 billion.

“The increase in spending on drugs isn’t the problem. The demand for drugs is growing because of increasingly widespread chronic diseases, population ageing and new treatment possibilities. However, it’s important to examine how to optimally use money for drugs, i.e. check a drug’s efficacy in relation to its price, and that is the goal of pharmacoeconomics, which isn’t sufficiently developed in Croatia,” says Marijana Badjun, author of the study.

Hospital debts mounting, wholesale drug suppliers waiting, state intervening

Badjun underlines the need for detailed and transparent statistical data on expenditures in Croatia’s health system, notably for hospital healthcare. She says it is also necessary to analyse the market of highly expensive drugs and look for ways to control the constant increase of public outlays for drugs without undermining the quality of healthcare.

Badjun recalls that the government and wholesale drug suppliers agreed recently that the HZZO should pay HRK 500 million from the state treasury to hospitals for the settlement of part of their debt to the suppliers, which exceeds HRK 4.2 billion.

Excluding hospitals, Croatia second to last in EU in per capita spending

Badjun says it is useful to look at drug consumption in Croatia in the international context.

Organisation for Economic Co-operation and Development data on drug spending do not include hospitals. If they did, the status of Croatia and other countries would be different.

Excluding that, Croatia is second to last in the EU with US$ 388 per capita according to purchasing power parity. Only Denmark spends less ($399), while Germany tops the rankings with $844 per capita.

(€1 = HRK 7.5)