Healthcare expenditures, in economic reports and overall budgetary spending, have decreased in 2022, according to official data from the Institute of Statistics (INSTAT), at a time when the country’s population’s needs for these services are increasing due to aging and the growing burden of diseases.

Public expenditures in the healthcare sector for 2022 amounted to 63.8 billion lek. In relation to Gross Domestic Product (GDP), they reached 2.98% and marked an annual decrease of 0.44 percentage points. When expressed as a percentage of total public expenditures, they recorded a decrease of 0.90 percentage points compared to 2021.

Budgetary expenditures for healthcare in relation to GDP were at the lowest level since 2017.

The economy and budgetary capacities have increased over the last decade, but funding for essential healthcare services, such as drug reimbursement and primary care, has remained stagnant at a time when the needs for pharmaceutical products and healthcare services in an aging population are rising.

Official indicators report that there is an unequal distribution of funds within the healthcare budget.

For almost a decade, the drug reimbursement budget has remained almost unchanged, while budget revenues have doubled, and financial resources of the Mandatory Health Insurance Fund have increased.

In 2013, expenditures for drug reimbursement were 2.1% of total budget expenditures, while in 2024, this ratio worsened, as they accounted for only 1.6% of total budget expenditures.

From 2019 to 2024, the Mandatory Health Insurance Fund budget (the structure that finances public healthcare services) has increased by around 40%, while the drug reimbursement voice has increased by only 20%, according to official data.

In 2019, the reimbursement fund accounted for 24% of the total expenditures of the Mandatory Health Insurance Fund, while in 2024, only 20.6%.

The increase in funds for healthcare is being absorbed by PPP concessions that have been given for some non-core services under investigation for abuses, and so far, there have been some arrests.

For example, for the laboratory services concession next year, 1.85 billion lek is planned, or 42% more than the value specified in the original contract.

Also, the sterilization contract will be funded next year with 1.75 billion lek, up from 1.2 billion that were stipulated in the contract’s annual payments.

The population’s needs for medications are increasing excessively due to the spread of non-communicable diseases, as evidenced by drug imports, which increased by 70% from 2013 to 2022.