German Pharmacies. Figures Data Facts Legal disclosure:

Transcription

1 German Pharmacies Figures Data Facts 2009 Legal disclosure: Published by the ABDA Federal Union of German Associations of Pharmacists Jägerstr. 49/ Berlin Germany Print: blueprint berlin gmbh Sources: ABDA-Statistik Bundesministerium für Gesundheit Center for Drug Information and Pharmacy Practice Europäische Kommission Gesundheit Österreich GmbH, ÖBIG 2006 IMS HEALTH GmbH & Co. OHG infas Institut für angewandte Sozialwissenschaft GmbH Institut für Demoskopie Allensbach Pro Generika e.v. Reader's Digest Statistisches Bundesamt The Nielsen Company GmbH Verein Deutsches Arzneiprüfungsinstitut e.v. YouGovPsychonomics AG

2 Contents Community pharmacies Numbers of pharmacies...4 Pharmacies in the German states... 5 Trends in the number of jobs in community pharmacies Pharmacists and pharmacy students... 8 Pharmacy trainee positions... 9 Pharmacy services Pharmacy image Pharmacy density in Europe Community pharmacies Pharmacies in the health care system SHI expenditure on pharmaceuticals (excl. co-payments) Distribution of the value added Allocation of total SHI expenditure Distribution of miscellaneous costs Vaccine sales Statutory pharmacy and manufacturer rebates Rebated pharmaceuticals Co-payments for pharmaceuticals Co-pay exemptions Pharmaceuticals with and without reference price Prescribed pharmaceuticals (SHI) Pharmaceutical expenditure per SHI-member Pharmaceutical expenditure per person Distributions of pharmacies according to turnover Structure of pharmacy sales Structure of complementary product range Drug-related problems (DRP) concerning self-medication VAT on pharmaceuticals in the EU

3 Numbers of pharmacies Pharmacies in the German states Number of pharmacies (incl. subsidiaries) German state Public Independent pharmacies in 2009 pharmacies* Subsidiaries Baden-Württemberg 2,755 2, ,569 21,465 21,305 21,392 21,476 21,551 21,570 21,602 21,548 Bavaria 3,439 2, Berlin Brandenburg Subsidiaries Bremen Hamburg ,228 1,796 2,356 2,851 3,224 Hesse 1,621 1, Mecklenburg-West Pomerania Lower Saxony 2,107 1, Pharmacies opened North Rhine 2,507 2, Westphalia-Lippe 2,230 1, Rhineland-Palatinate 1, Saarland Pharmacies closed Saxony Saxony-Anhalt Schleswig-Holstein Thuringia Total 21,548 18,324 3,224 Figures as at year-end Figures as at year-end; * Pharmacies with operating licence in accordance with 2 of the Apothekengesetz (pharmacy regulations) 4 5

4 Trends in the number of jobs in community pharmacies Year-end Pharmacists 45,869 46,513 46,140 Of which female (%) ,014 46,276 46,953 47,766 48,030 48, Pre-registration trainee pharmacists 1,748 1,520 1,387 1,431 1,534 1,518 1,506 1,327 1,287 Pharmaceutical engineers 10,294 10,218 9,600 9,602 9,266 8,292 8,413 8,196 8,056 Pharmaceutical technical assistants (PTA) 40,805 41,495 42,385 43,946 46,431 48,656 49,874 51,907 53,734 Pharmaceutical commercial employees (PCE) / other 38,614 40,091 37,636 35,812 36,454 38,355 36,026 36,020 35,769 Total jobs 137, , , , , , , , ,

5 Pharmacists and pharmacy students Pharmacy trainee positions Pharmacists Pharmacists in: Percentage of women Community pharmacies 48,030 48, Of which managers 18,751 18, ,287 Hospital pharmacies 1,874 1, Industry, administration, organisation, science 7,575 7, Total emloyed pharmacists 57,479 57, ,155 2,645 Pharmacy students 2004/ , / ,069 10,087 Total number of trainee positions 2006/ , / ,721 PCEs in training Pre-registration trainee pharmacists PTA trainees 2008/ ,

6 Pharmacy services Pharmacy image Approximately 4 million people visit public pharmacies every day. In 2009, pharmacies 87 % of Germans have a high degree of trust in pharmacists 1 - reported a total of 7,400 suspected cases of medication risks to the Drug Commission of the German Medical Association. Main complaints referred to errors in packaging (30 %), unwanted medication effects and reports of misuse (29 %) as well as galenic deficiency (20 %). --processed some 16 million prescriptions covered by the statutory health insurance (SHI), 65 % of which were conventional, 20 % methadone, 11 % cytostatic and 4 % parenteral formulation. Training courses 82 % 65 % of Germans feel that pharmacies provide good-quality service, and consider them to be some of the best service providers in Germany 2 of Germans go to the pharmacy first when they have minor health issues 3 In 2009, approximately 119,000 people took part in nearly 2,300 training courses offered by the Council of Pharmacists more than ever before. Grade 2.4 is the mark Germans give to owner-run pharmacies and is equivalent to good 4 Night and emergency service - Approx. 2,000 pharmacies per night Grade 1.8 is the mark Germans give to owner-run pharmacies concerning healthcare of their children 5 - More than 20,000 patients per night - More than 7 million packs provided outside the regular opening hours - Especially important for children (and their parents): above-average percentage of SHI pharmaceuticals dispensed during night and emergency service is prescribed by paediatricians. Sources (representative surveys) 1 Reader's Digest Allensbach YouGovPsychonomics infas infas

7 Pharmacy density in Europe People per pharmacy* Denmark 16,800 Sweden 10,700 Netherlands 9,400 Slovenia 7,400 Austria 6,900 Finland 6,500 Pharmacies in the health care system Czech Republic 5,500 Luxembourg 5,200 Hungary 5,000 United Kingdom 4,900 Slovakia 4,600 Estonia 4,300 Germany 3,800 Portugal 3,800 Poland 3,500 Italy 3,300 Ireland 3,000 France 2,700 Latvia 2,600 Lithuania 2,300 Spain 2,100 Belgium 2,000 Malta 1,900 Cyprus 1,700 Greece 1,200 * Germany: ABDA-Statistik 2009; all other countries: last available year according to ÖBIG 12 13

8 SHI expenditure on pharma ceuticals (excl. co-payments) Distribution of the value added Every 100 spent by SHI on pharmaceuticals is allocated as follows: (=14.9 %) 4.49 (=16.0 %) (=65.2 %) Industry (=3.9 %) In bn (=100 %) Total amount spent by SHI on pharmaceuticals in 2009 Exchequer (VAT) Pharmaceutical industry and purchased materials and services (such as raw materials) Pharmaceutical wholesalers VAT (exchequer) Pharmacies Wholesalers Pharmacies 14 15

9 Allocation of total SHI expenditure Total SHI expenditure (in bn) Of which (%) Doctors Dentists Dentures Remedies and therapeutic aids Hospitals Administrative expenditure Misc. costs Pharmaceuticals** Of which is allocated to pharmacies based on the Drug Price Ordinance (Arzneimittelpreisverordnung) * * Provisional ** From pharmacies 16 17

10 Distribution of miscellaneous costs Vaccine sales* in % In m Sick pay 4.2 Transportation expenses Pregnancy, maternity 1.9 Home care ,257 Pharmaceuticals from others ,349 Social services 1.5 Ambulant & inpatient treatment, rehab ,176 Dialysis in doctors' practices 1.0 Early diagnosis measures 0.9 Others 2.0 Of which tick-borne meningoencephalitis Of which flu Of which pneumococcus Of which human papillomavirus (HPV) Total 18.2 In 2007, vaccinations were included in the SHI catalogue of required services. * Vaccine against H1N1 ("swine-flu") is not included, as settlement is undertaken by the Federal States

11 Statutory pharmacy and manufacturer rebates Rebated pharmaceuticals 9,300 Number of rebate contracts 1,235 1,319 1, Involved health insurance companies Involved pharmaceutical manufacturers 26,900 Number of rebated pharmaceuticals (Central Pharmaceutical Number) 60 % Share of rebated pharmaceuticals subject to no or reduced co-payments Mio. Rebated packs of generic pharmaceuticals In m Pharmacy rebate Manufacturer rebates (excl. rebate contracts) 20.9 Mio. Number of data sets that need to be processed by Pharmacy IT Figures as at year-end

12 Co-payments for pharmaceuticals Co-pay exemptions Co-payments in m Number of patients who are exempt from the prescription charge (hardship cases in accordance with 62 SGB V): 6,643,362 6,837,531 2,314 2,149 1,979 1,626 1,674 1, Number of patients who exceed the annual prescription charge limit of 2 % of their gross annual income: Charge per unit in 673, , Number of patients who exceed the annual prescription charge limit of 1 % of their gross annual income (chronically ill patients): ,969,805 6,403,

13 Pharmaceuticals with and without reference price Prescribed pharmaceuticals (SHI) Average unit price in Prescriptions per member Pharmaceuticals per prescription Prescribed pharmaceuticals per member x x x Pharmaceuticals with reference price Pharmaceuticals without reference price x x x Number of units provided in m x x x x Pharmaceuticals with reference price Pharmaceuticals without reference price 24 25

14 Pharmaceutical expenditure per SHI member * Per member (excl. pensioners) in Per pensioner in Per member (incl. pensioners) in Approx. 30 % of the members are pensioners. *Provisional 26 27

15 Pharmaceutical expenditure per person Distribution of pharmacies according to turnover Pharmacy share according to turnover (%) Pharmaceutical expenditure per person Total: 515 Over-the-counter pharmaceuticals Prescription pharmaceuticals <0.50 <0.75 <1.00 <1.25 <1.50 <1.75 <2.00 <2.25 <2.50 <2.75 <3.00 >3.00 Incl. VAT Turnover in m (excl. VAT) 28 29

16 Structure of pharmacy sales Measured in sales value: Measured per units: Pharmacy sales in 2009 (excl.vat) 39.2 bn = 100 % Prescriptions in ,426 m units = 100 % 1) 2.0 bn = 5.1 % Pharmaceuticals 35.5 bn = 90.6 % 2) 1.7 bn = 4.3 % Prescription pharmaceuticals 766 m units = 53.7 % Pharmacy-only pharmaceuticals (non-prescription) 614 m units = 43.1 % 1) 46 m = 3.2 % Prescription pharmaceuticals 30.8 bn = 78.6 % Pharmacy-only pharmaceuticals (non-prescription) 4.4 bn = 11.2 % 3) 0.3 bn = 0.8 % Prescribed 121 m units = 8.5 % Not prescribed 493 m units = 34.6 % Prescribed 1.1 bn = 2.8 % Not prescribed 3.3 bn = 8.4 % Volume of pharmaceuticals covered by SHI, private insurance and other 887 m units = 62.2 % Self-medication 539 m units = 37.8 % Value of pharmaceuticals covered by SHI, private insurance or other Self-medication 31.9 bn = 81.4 % 3.6 bn = 9.2 % 1) Supplementary assortment 2) Patient care products 3) Unrestricted OTC pharmaceuticals* 1) Unrestricted OTC pharmaceuticals* * Pharmaceuticals which may be sold outside pharmacies (e.g. by chemists) 30 31

17 Structure of complementary product range Drug-related problems (DRP) concerning self-medication Almost every 5th patient request for self-medication pharmaceuticals is associated with one or more drug-related problems (DRP) % of DRP occur in conjunction with the four most common indications, i.e. pain, respiratory-, gastrointestinal- and skin disorders % of DRP are inappropriate self-medication, inappropriate product request, wrong dosage, and duration of drug use (including abuse) was too long. 0.3 If a patient has a medication record at the pharmacy, significantly more cases of wrong dosage and drug-drug interactions can be identified % of DRP can be resolved in pharmacies. 3.7 Total Sales in bn (excl. VAT) Medical products and therapeutic aids Hygienic and cosmetic products Vitamins and minerals Other * includes supplementary assortment and patient care products 32 33

18 VAT on pharmaceuticals in the EU* Tax rate for pharmaceuticals General VAT rate Tax rate for pharmaceuticals General VAT rate Denmark Bulgaria Germany Greece Latvia Italy Hungary Lithuania Portugal Spain Luxembourg France Refundable pharmaceuticals Austria Non-refundable pharmaceuticals 5.5 Slovakia Sweden Prescription pharmaceuticals Estonia Over-the-counter pharmaceuticals 25.0 Romania Ireland Oral medication Czech Republic Non-oral medication 21.5 Slovenia UK National Health Service pharmaceuticals Finland Over-the-counter pharmaceuticals 15.0 Poland Belgium Malta Cyprus Netherlands * Tax rates as at