Household spending in pharmacies: how much and on what? Applied research in North Macedonia to improve tracking of health expenditure

The document is an applied research study conducted in North Macedonia to improve the tracking of health expenditure. The study was produced by the WHO Barcelona Office for Health Systems Financing and emphasizes the significance of pharmaceutical expenditure in the health budgets of countries. In North Macedonia, pharmaceuticals account for a significant portion of national health spending, with households bearing more than half of the costs. The report delves into the challenges of assessing the actual use of medicines and medicinal products purchased without prescriptions. The study utilized the Anatomic Therapeutic Chemical (ATC) classification to predict the use of non-prescribed medicines. The research found that about 75% of out-of-pocket spending in community pharmacies is related to medical goods, with a dominant share on pharmaceuticals. Furthermore, 70% of the coded spending is on medicines used to treat noncommunicable diseases. The study recommends a more accurate tracking system for pharmaceutical spending to provide crucial insights into household spending patterns in pharmacies, which can inform policy-making in countries with similar pharmaceutical environments.