Table 2.
User charges for publicly financed outpatient prescribed medicines and catastrophic health spending, 2019 or the latest available year before COVID-19.
| Country | Year | Catastrophic health spending (% households) | Type of user charge | Exemption from user charges | Cap on user charges |
|---|---|---|---|---|---|
| NL | 2015 | 0.5 | D, RP | Yes, but not based on income | No, but the deductible limits co-payments |
| SI | 2018 | 0.8 | PC, RP | Yes, based on income | No, but VHI covers co-payments for >90% of the population |
| IE | 2016 | 1.2 | FC | Yes, but not based on income | Yes, based on income |
| UK | 2019 | 1.5 | FC | Yes, based on income | Yes, but not based on income; only for people who request it in advance |
| ES | 2019 | 1.6 | PC | Yes, based on income | Yes, based on income, but only for pensioners |
| SE | 2015 | 1.6 | D, PC | Yes, based on income | Yes, but not based on income |
| FR | 2017 | 2.1 | FC, PC | Yes, based on income for FC, but not based on income for PC | No, but VHI covers co-payments for >90% of the population and is provided for free to people with low incomes |
| LU | 2017 | 2.3 | PC, RP | Yes, but not based on income | Yes, based on income |
| DE | 2018 | 2.4 | PC, RP | Yes, but not based on income | Yes, based on income |
| DK | 2015 | 2.6 | D, FC, PC, RP | Yes, based on income | Yes, but not based on income |
| CH | 2017 | 2.9 | D, PC | Yes, but not based on income | Yes, but not based on income |
| AT | 2015 | 3.2 | FC | Yes, based on income | Yes, based on income |
| HR | 2019 | 3.6 | FC, RP | Yes, but not based on income | No, but VHI covers co-payments for most people who have to make co-payments and is provided for free to people with low incomes |
| FI | 2016 | 3.8 | D, PC | Yes, based on income | No, but there is a threshold for reduced co-payments |
| BE | 2018 | 3.8 | FC, PC, RP | Yes, but not based on income | Yes, based on income |
| CZ | 2019 | 4.2 | RP | No | Yes, but not based on income |
| TR | 2018 | 4.3 | FC, PC | Yes, but not based on income | No |
| CY | 2015 | 5.0 | FC | No | No |
| SK | 2015 | 5.1 | PC | Yes, but not based on income | Yes, but not based on income and only for disabled people, pensioners, and people above 60 |
| IL | 2019 | 5.7 | PC | Yes, but not based on income | Yes, but not based on income and only for people with chronic conditions |
| MK | 2018 | 6.5 | PC, RP | Yes, but not based on income | No |
| MT | 2015 | 6.9 | None for some covered people | NA | NA |
| EE | 2019 | 7.2 | FC, PC, RP | Yes, but not based on income | No, but there is a threshold for reduced co-payments |
| PL | 2019 | 8.6 | FC, PC, RP | Yes, but not based on income | No |
| BA | 2015 | 8.8 | FC, PC, RP | Yes, based on income (some cantons) | No |
| EL | 2019 | 8.9 | FC, PC, RP | Yes, based on income | No |
| ME | 2017 | 9.4 | FC | Yes, based on income | No |
| IT | 2019 | 9.4 | FC, RP | Yes, based on income (some regions) | No |
| PT | 2015 | 10.6 | PC | Yes, but not based on income | No |
| HU | 2015 | 11.6 | PC | Yes, but not based on income | No |
| MD | 2019 | 11.7 | FC, PC, RP | Yes, based on income | No |
| RS | 2019 | 12.2 | FC, PC | Yes, but not based on income | No |
| AL | 2015 | 12.5 | PC, RP | Yes, but not based on income | No |
| RO | 2015 | 12.5 | PC | Yes, but not based on income | No |
| LV | 2016 | 15.0 | FC, PC, RP | Yes, based on income | No |
| LT | 2016 | 15.2 | PC, RP | Yes, but not based on income | No |
| GE | 2018 | 17.4 | PC | Yes, based on income | No |
| UA | 2019 | 18.0 | RP | Yes, but not based on income | No |
| BG | 2018 | 19.2 | PC, RP | Yes, but not based on income | No |
| AM | 2019 | 20.3 | PC | Yes, based on income | No |
Notes: see the list of abbreviations and the note on the Netherlands in Fig. 1. Countries are sorted by the incidence of catastrophic health spending (lowest in Slovenia, highest in Armenia). Information on user charges is for the same year as data on catastrophic health spending and may not reflect the current situation. D: deductible. FC: fixed co-payment. PC: percentage co-payment. RP: reference pricing. Malta has no user charges for covered outpatient prescribed medicines; people pay the full price out of pocket if they are not entitled to a ‘yellow’ or ‘pink’ card. The range of covered outpatient prescribed medicines varies across countries.