Health spending per capita second highest in the EU

A pharmacy in Culemborg, Netherlands
© ANP
In 2020, average per capita spending on health care in the Netherlands was higher than in almost all other countries of the EU. The out-of-pocket payments, on the other hand, were comparatively among the lowest. This is evident from the publication Health at a Glance: Europe 2022 by the OECD and Eurostat.
Annual health care expenditure in the Netherlands stood at 5,180 euros per inhabitant on average in 2020. This means that average per capita health spending in the Netherlands exceeded that of 25 other EU countries. Only Germany had higher per capita expenditure at 5,736 euros. Health spending was lowest in Romania at 1,696 euros per capita. The figures have been adjusted for price differences in order to allow for comparison. In other words, the amounts quoted for other countries reflect what this expenditure would have been in the Netherlands.

Per capita health expenditure1), 2020
Countrycountry code
Belgium4469
Bulgaria1755
Cyprus2452
Denmark4706
Germany5736
Estonia2256
Finland3806
France4520
Greece2055
Hungary1986
Ireland4441
Italy3097
Croatia1719
Latvia1841
Lithuania2382
Luxembourg4652
Malta²⁾3499
Netherlands5108
Austria4862
Poland1890
Portugal2767
Romania1696
Slovenia2872
Slovakia1757
Spain3073
Czechia3145
Sweden4759
Source: EUROSTAT
1) Figures based on purchasing power parity in euros, proportionate to Dutch levels 2) Malta: 2019

Out-of-pocket payments low in the Netherlands

People in the Netherlands, in France and in Luxembourg were paying the least out of their own pockets with respective shares in total health expenditure of 9.3, 8.9 and 8.4 percent. Bulgarians paid the highest share, 35.5 percent. These out-of-pocket contributions to healthcare providers include, among other things, health insurance deductibles and contributions to mandatory schemes.
A substantial share of the out-of-pocket payments is usually spent on pharmaceuticals. However, there are major differences between the countries: in Cyprus, roughly 10 percent of the out-of-pocket payments went to pharmaceuticals, against 70 percent in Bulgaria. Another large item in out-of-pocket payments tends to be dental care.

Out-of-pocket payments to health care providers, 2020
LandShare of health spending financed through out-of-pocket payments (%)
Bulgaria35.5
Malta ¹⁾34.1
Greece33.4
Latvia31.9
Lithuania28.7
Portugal27.8
Hungary25.5
Estonia21.4
Italy21.3
Spain19.6
Poland19.5
Romania19.0
Slovakia18.8
Austria16.8
Finland16.4
Belgium16.0
EU-27 ²⁾14.4
Cyprus14.0
Sweden13.0
Denmark12.8
Slovenia12.5
Germany12.4
Czechia11.5
Ireland10.5
Croatia10.5
Netherlands9.3
France8.9
Luxembourg8.4
Source: CBS, EUROSTAT
1) Malta: 2019 2) EU-27: estimate

Out-of-pocket payments for pharmaceuticals slightly above EU average

Despite the relatively low out-of-pocket share in total health expenditure, Dutch spending on pharmaceuticals only (obtained from the pharmacy, the chemist or the supermarket) was slightly above the European average of 28 percent, namely 31 percent. Bulgarians spent the most on their own medication at 76 percent. The smallest contribution was made in Cyprus (10 percent). The proportion of spending on pharmaceuticals that does not come out of people’s own pockets is paid by insurance companies or the government. In some countries, pharmaceuticals are also reimbursed through schemes of companies or non-profit institutions.

Out-of-pocket payments in pharmaceutical spending, 2020
LandShare spent out of pocket on pharmaceuticals, 2020 (%)
Bulgaria75.7
Poland65.0
Latvia 58.3
Lithuania53.9
Romania52.2
Denmark52.2
Hungary50.0
Malta ¹⁾47.6
Sweden45.9
Greece45.2
Portugal44.2
Finland40.2
Estonia38.8
Czechia36.4
Italy36.3
Belgium33.9
Spain33.1
Slovakia31.8
Netherlands31.5
Austria31.0
EU-27 ²⁾28.3
Luxembourg27.9
Slovenia24.0
Ireland19.2
Germany17.9
Croatia17.8
France12.8
Cyprus10.4
Source: CBS, EUROSTAT
1) Malta: 2019 2) EU-27: 2019