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World Bank: Albanians spend in a year 700-750 million dollars out of pocket for health

2024-06-28 10:20:06Biznes SHKRUAR NGA REDAKSIA VOX

World Bank: Albanians spend in a year 700-750 million dollars out of pocket for

As a developing country, Albania has low per capita spending on health services, including medications, but out-of-pocket payments are at very high levels for a country that offers free health care.

According to data from the World Bank database in 2021, the per capita expenditure on health in Albania was 465 dollars. Of this amount, according to the World Bank, 59.7%, or $277 per capita, are out-of-pocket expenses.

In total for a population of about 2.7 million, out-of-pocket costs for 2021 were about $750 million. If we calculate a resident population of around 2.5 million inhabitants, the out-of-pocket expenses for health are no less than 700 million euros per year.

According to the World Bank methodology, Out-of-Pocket Expenditure is any direct expenditure by households, including gratuities and payments in kind, to health practitioners and suppliers of pharmaceutical products, therapeutic devices and other goods and services whose primary purpose is to contribute to restoring or improving the state of health. of individuals or population groups. These are part of private health expenditures. These expenditures are measured through national household questionnaires.

Net out-of-pocket payments have been increasing in recent years as the population in need of medication continues to grow.

The aging population and the Covid-19 pandemic have increased the number of chronically ill people who need more than one treatment.

Medications are often purchased out of pocket at the pharmacy. The data of INSTAT informs that the imports of medicines are about 26-28 billion ALL per year, adding the margin of wholesale and retail distribution (25%), the final value reaches 35 billion ALL.

Of this amount, about 12 billion ALL is reimbursed by the state (mainly for pensioners or chronically ill), while the citizens cover with their own expenses about 23 billion ALL per year (about 230 million dollars). There are also drugs that are smuggled in and are expensive, which are not recorded in the official figures.

The Compulsory Insurance Fund announced that chronic diseases are increasing rapidly, while funds for the reimbursement of medicines have not been sufficient in 2023.

In the middle of 2023, the government increased the budget for reimbursement of medicines to 12 billion ALL from 11.4 billion ALL, which was at the beginning of the year, but even these were not enough and arrears have been generated.

At the end of the year, from the list-indicators accepted for the reimbursement of drugs and equipment, about ALL 796 million remained unpaid. Compared to the previous year, the year-end liabilities increased by 5.8%, or for the value of 673 million ALL, declares FSDKSH.

In reimbursement lists are often medications that are not effective, causing many citizens to turn to pharmacies.

Also, citizens pay out of pocket for health services in public hospitals. This amount is practically immeasurable, as out-of-pocket payment has become a culture in the health system, with the perception that otherwise one does not receive the requested service.

The recent investigations of the Prosecutor's Office of Tirana even revealed cases when patients were directed to buy medicines that they should take in the hospital, or were forced to be treated in private clinics.

Another part of the population, which has financial opportunities, goes to private hospitals, which in the last decade increased rapidly, after seeing the high costs of Albanians to be treated abroad, mainly in Turkey or Greece.

Other Monitor data, compiled from official balance sheets, shows that the annual turnover of the country's top five private hospitals in 2021 was $120 million, boosted by the pandemic, to then drop to around $100 million in 2022. (see the income graph of the main private hospitals).

In addition to spending in private hospitals in the country, there are many who turn to hospitals abroad, such as in Italy, Turkey, Greece or Germany, in search of a better quality service, which is not offered in the country, especially in the public health service. Even these expenses are practically incalculable.

Increase in out-of-pocket expenses

Data from the World Bank, referring to the World Health Organization, revealed that over the past 20 years, out-of-pocket health expenditures have increased.

In 2000, for every 100 ALL spent on health, 46.5 ALL were from internal government funding for this item, 1.7 ALL from external sources and 51.8 ALL from the citizens' own pockets, according to data from the World Bank, which refers to the World Health Organization.

Two decades later, despite numerous investments, not only have health expenditures not improved, on the contrary, citizens, who pay 3.4% of salary as tax for health insurance, have paid more and more out of pocket. World Bank data indicates that in 2021, for every 100 Lek spent on health, Albanians pay out of pocket about 60 Lek, or 60%, about 8 percentage points more than in 2000.

Compared to all other European countries (not including the former Soviet Union states), Albania holds the record for out-of-pocket expenses.

Second behind us is North Macedonia, with 41.7%, followed by Montenegro (38.1%), Serbia (35.8). The lowest indicator in the region is in Bosnia-Herzegovina (30.7%), while the data for Kosovo are missing.

World Bank: Albanians spend in a year 700-750 million dollars out of pocket for


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