Albanians face high healthcare expenses directly from their pockets, but this type of expenditure seems to have increased further after the Covid-19 pandemic.

According to recently updated data from the World Health Organization (WHO), in 2021 an Albanian spent an average of 465 US dollars on health. This amount, at 59.7% (277 US dollars), was covered from themselves, while the remaining 39.7% came from Government spending from the state budget.

As per WHO data, Albanians’ out-of-pocket health expenses have significantly increased after the pandemic. In 2015, this indicator was 57.3%, and since then, it has increased by 2.5 percentage points.

The Government has increased budgetary capacities, but out-of-pocket expenses for healthcare have risen over the decades of transition instead of decreasing. As observed from WHO data, in 2005 Albanians paid 49.3% of healthcare costs from their pockets, while in 2021, this indicator reached 59.7%.

WHO calculates that between 2015-2021, Albanians’ healthcare expenses increased by 82%. During this period, the Covid-19 pandemic seems to have had an unusual impact.

Compared to all other European countries (excluding former Soviet Union states), Albania holds the record for out-of-pocket expenses. The second is North Macedonia, with 41.7%, followed by Montenegro (38.1%), Serbia (35.8%). The lowest indicator in the region is in Bosnia and Herzegovina (30.7%), while data for Kosovo is missing. In high-income countries, this indicator is lower than 20%.

Expenses increased during the pandemic

In 2020, health expenses for Albanian families reached a record of 5.6% of total expenses, up from 4.9% the previous year, indicating that Covid-19 treatment was borne out of pocket (according to INSTAT, the weight of health expenses remained unchanged in 2021).

While European families had this indicator at 4.5% in 2020, up from 4.4% the previous year, with better healthcare services providing them proper care (in 2020, Albania had one of the highest excess mortality rates in Europe due to the pandemic).

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

Official indicators suggest that there is unfair allocation 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.

From 2013 to 2022, the imports of pharmaceutical products in value increased by 11.3 billion lek, while funds for drug reimbursement increased by 3 billion lek, according to official data.

In 2022, the imports of pharmaceutical products reached 28 billion lek, around 270 million euros, while the state reimbursement fund was 11.4 billion lek. Data shows that Albanian patients funded out of pocket for the purchase of medicines or 61% of the value of imported pharmaceutical products in 2022.