Pharmacy performance

from Wikipedia, the free encyclopedia

In the healthcare system, pharmacy service is understood to mean the pharmacies' expenses that are not related to the drug .

Basics

In principle, pharmacies sell drugs and other pharmaceuticals in the sense of a trading company . In a publicly financed or at least subsidized health system, not only the drug itself but also the other expenses of the pharmacy are compensated from the financing system: Pharmacies form an important sector of the health system, and local supply is just as politically desirable as state-controlled drug prices. Therefore, pharmacies are usually not run as purely self-financed commercial enterprises, but are included in the financing through health insurance companies and health insurance companies. In addition, advising the patient and, in particular, providing information about the drug (“Ask your doctor or pharmacist”) is an important aspect of the pharmacy's service. This time expenditure, which goes beyond the customary customer service , is also compensated, as is the maintenance of public statistical data on medication and night and on- call services . In addition, pharmacies usually still handle any prescription fees on the part of the patient.

This paid effort is called a pharmacy service. It mainly includes the actual operating expenses, i.e. the operating costs and labor costs (the wages of the employees), and possibly also the pharmacy's own production. Pharmacy services and expenses for medication (cost of goods : cost price and pharmacy margin - i.e. dealer price and trading margin ) together basically form the revenue (sales) of a pharmacy, compensation and pharmacy margin the income .

Originally, the task of a pharmacy was to produce a preparation from the pharmaceutical raw materials that were to be kept in stock on the instructions of the doctor (the prescription ). This task and in-house production has largely faded into the background due to the development of the pharmaceutical industry , which is why the pharmacy's service today is mainly in the trade with purchased medicines.

Because the pure distribution of public medication is not particularly lucrative in spite of everything, many pharmacies today also sell over-the-counter therapeutics , cosmetics and other health products . This division is not counted as part of the pharmacy service in the actual sense, but is that of a normal trading company outside of public welfare.

A change in the pharmacy landscape results from the online drug trade ( mail order pharmacies ). One problem area here is the drug trade that is illegal or in a gray area in the social system, for such trading ventures a large part of the operating costs of a pharmacy, but in particular they save the effort of the usually legally prescribed consultation and statistics obligation, and for all online Dealers provide emergency care (night / on-call service).

National

Austria

Financial flows in the Austrian healthcare system
      Bonuses Private insurance   Special services    
                             
                        Catalog services ( after DRG )      
        Contributions Health insurance (
compulsory insurance)
         
                         
        Taxes FA                        
          BM (Fin) countries BGA          
       
                Art. 15a BV-G   budget        
Country Fund (
LGF)
   
                           
                
population   Deductibles   Fund KA                  
     
 AN , AG (←)   fee      
        Private KA                
    some deductibles *   PRIKRAF      
     
              Expense coverage        
or. (←) Outpatient clinic        
                   
    some deductibles *           Flat rate
individual services
       
  (←) (practicing)
doctor
       
          Exp. f. Drugs
of pharmacy services
 
    Prescription fee **                          
patient (←) pharmacy        
                   
                           
        reimbursement        

(Fin) Ministry of Finance distributes the budget for the Ministry of Health ;
* flows directly to KV carriers;
** flows via pharmacy to health insurance providers;
(←) partly direct reimbursement or exemption for mandatory verse.
Reds: Government Sector,
Yellows: Private Sector

Diagram according to Ziniel (2005)

In Austria, pharmacy services are covered by health insurance companies (compulsory insurance) .

Statutory health insurance expenditures amount to around € 15 billion (2012: € 5.189 billion). Pharmacy services only account for around 3% of this (2012: € 421 million, 2.8%). In comparison, the drug expenditure that runs through the pharmacies - excluding medical pharmacies - i.e. the trading volume as transitory items comprises a good 10% (expenditure for drugs minus VAT and prescription fee in total 2012: 1.99 billion €, 13.1%), almost 4 times. The processed prescription fee amounts to almost € 400 million (2012: € 388 million).

Statutory health insurance expenditure (2012)
breakdown in billions of euros in %
Medical help 4,568 30.1
Institutional care 4,446 29.3
Administrative burden 0.430 2.8
Medicines including VAT 3.005 19.8
Medicines excl. VAT 2.721 17.9
Drug value creation public pharmacies ( pharmacy service ) 0.421 2.8
medical pharmacies 0.064 0.4
other reference 0.012 0.1
Wholesale 0.174 1.1
Industry 2.049 13.5
Remedies 0.240 1.6
Other expenses 2,500 16.5
Total expenses 15,189 100.0
Sources: Social insurance, Austrian Chamber of Pharmacists

For the 1,300 public pharmacies, the pharmacy service averages over € 300,000. Total health insurance sales amount to an average of € 1.7 million, with a further € 800,000 being private sales. A pharmacy processes an average of another € 300,000 per year in terms of prescription fees.

In relation to the insured (99% of the population are insured in the health insurance through compulsory insurance), the pharmacy benefit amounts to 50 € per person per year. The Austrian spends a good € 400 (2011: € 416.1) on medication each year (about 70% of which on health insurance).

In other words, around a tenth of the pharmaceutical budget is used to maintain the nationwide pharmacy landscape. Mail order in Austria is in principle only permitted for non-prescription drugs, so it does not play a role in public health care.

Individual evidence

  1. For example, there is also widespread area protection for pharmacists, i.e. a restriction on the establishment in the catchment area of ​​an existing pharmacy.
  2. ^ Austrian Chamber of Pharmacists (Ed.): Pharmacy in Figures 2014 . onA, Chapter 6.2 Expenditures for pharmacy services , p. 43 ( pdf , 2.1 MB, apotheker.or.at).
  3. Reproduced in: Ch. Herber; J. Weidenholzer (Ed.): Assessment approach of the implementation of the health reform 2005 . Linz 2007, p. 133 (PDF, ooegkk.at, accessed on July 20, 2014) - there “Ziniel (2005)” without further details.
  4. a b c Austrian Chamber of Pharmacists: Pharmacy in Figures 2014 , Chapter 6.1 Health Insurance Expenditures , table breakdown of expenses p. 42 ( pdf , 2.1 MB, apotheker.or.at).
  5. Austrian Chamber of Pharmacists: Pharmacy in Numbers 2014 , Chapter 6.3 Prescription Fees, p. 43 f ( pdf , 2.1 MB, apotheker.or.at).
  6. Austrian Chamber of Pharmacists: Pharmacy in Figures 2014 , Chapter 6.1 Health Insurance Expenditures , table breakdown of expenses on p. 41 ( pdf , 2.1 MB, apotheker.or.at).
  7. Austrian Chamber of Pharmacists: Pharmacy in Figures 2014 , Chapter 1.2 Business situation : table of sales development of the median pharmacy , p. 8.
  8. Low drug prices, low drug consumption. New drug study in Austria. In: Die Apotheke Heft 07/2011 ( article online , apotheker.or.at).