Household spending in pharmacies: how much and on what? Applied research in North Macedonia to improve tracking of health expenditure

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Abstract
Access to safe, effective, quality and affordable essential medicines is a central element of universal health coverage, and yet they are, in most countries, the main driver of out-of-pocket (OOP) spending on health and financial hardship. To address this challenge, evidence-informed decisions are required that can be tailored to the level of OOP spending on medicines and to the diseases and conditions for which people spend OOP in pharmacies. North Macedonia has made significant progress in recent years in developing a detailed and advanced tracking health spending based on the System of Health Accounts (SHA) 2011 framework. This report is based on applied research aimed at further improving the system for tracking OOP spending on pharmaceuticals, with the potential to inform policy-makers in other countries and in similar contexts. The research found that about one-fifth of community pharmacies' sales are non-medical goods, which may slightly increase the OOP on medicines, but in the case of North Macedonia doesn’t reduce total OOP spending. Thus, it is recommended that a distribution key should be defined and applied for separating non-medical goods whenever aggregated data includes such sales. To further inform decisions on medicines spending, when an anatomic therapeutic chemical coding of dispensed medicines is available or can be collected, it is useful to link and define pharmaceutical spending by major disease groupings based on the diseases classification of the SHA 2011 methodology. It is recommended that similar studies are conducted in other countries of the WHO European Region to improve the tracking OOP spending on medicines.Citation
World Health Organization. Regional Office for Europe. (2023). Household spending in pharmacies: how much and on what? Applied research in North Macedonia to improve tracking of health expenditure. World Health Organization. Regional Office for Europe. https://iris.who.int/handle/10665/368418. License: CC BY-NC-SA 3.0 IGO
Description
x, 41 p.ISBN
9789289060103 (PDF)9789289060110 (Print)
ISSN
2958-3950 (online)2958-3942 (print)