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DOI: 10.1055/a-2089-5142
Self-Medication in Europe: Economic and Social Impact on Individuals and Society
Selbstmedikation in Europa: Sozioökonomische Effekte auf den Einzelnen und die GesellschaftAbstract
Objectives To demonstrate the different monetary and time-related costs associated with the treatment of minor ailments (MAs) in the case of a general practitioner (GP) visit or self-medication with non-prescription medicines as an essential part of self-care in European countries. Ultimately, this is also intended to enable health policy statements with regard to an efficient allocation of resources in outpatient care.
Methods A simplified decision-analytical model is applied in which the self-purchase of a non-prescription medicine and a GP visit are considered as partial substitutes from the patient's perspective. In order to compare the decision paths of GP visit and self-medication in the sense of a cost-minimisation approach, the most relevant direct and indirect cost types are identified. Thirty countries are clustered following socioeconomic criteria. The value of self-medication is calculated for an individual MA case per Country Cluster, then the data is extrapolated to the entire population of countries and aggregated to a European value. Status quo and potential scenarios as well as relevant perspectives (patient, GP, healthcare system, national economy) are considered. Sensitivity analyses are conducted.
Results Almost 1.2 billion MA cases are treated by self-medication in Europe p.a., saving EUR 26.31 billion in direct costs and EUR 10.41 billion in indirect costs (status quo). On average, one euro spent on OTC medicines by consumers saves national healthcare systems and economies EUR 6.70. 10–25% of current GP visits could be substituted by self-care, creating an additional savings potential of EUR 17.60 billion.
Conclusion The study results reveal that self-medication in European countries is already associated with a high economic and social value for the individual and society. It is evident that current savings could be further increased by promoting self-care. Through responsible self-medication supported by an adequate health policy, resources and significant efficiency reserves for healthcare systems as well as national economies can be released. The resources freed up through an adequate self-care policy can play a significant role in building more resilient healthcare systems across Europe.
Zusammenfassung
Zielsetzungen Bei der Behandlung leichterer Gesundheitsstörungen führt die Inanspruchnahme eines Hausarztbesuchs zu anderen monetären und zeitlichen Kosten als die Selbstmedikation mit rezeptfreien Arzneimitteln. Die unterschiedlichen Kosten der beiden Behandlungsoptionen sollen auf europäischer Ebene aufgezeigt werden. Dies soll letztlich auch gesundheitspolitische Aussagen im Hinblick auf eine effiziente Ressourcenallokation in der ambulanten Versorgung ermöglichen.
Methodik Es wird ein vereinfachtes entscheidungsanalytisches Modell angewendet, in dem im Fall einer leichteren Gesundheitsstörung der Selbstkauf eines rezeptfreien Arzneimittels und der Besuch des Hausarztes als partielle Substitute aus Sicht des Patienten betrachtet werden. Um die Entscheidungspfade von Hausarztbesuch und Selbstmedikation im Sinne eines Kostenminimierungsansatzes zu vergleichen, werden die wichtigsten direkten und indirekten Kostenarten ermittelt. Dreißig europäische Länder werden nach sozioökonomischen Kriterien geclustert. Der Wert der Selbstmedikation wird zunächst einen einzelnen Behandlungsfall pro Ländercluster berechnet, dann werden die Daten auf die Gesamtpopulation der Länder extrapoliert und zu einem europäischen Wert aggregiert. Status quo und mögliche Szenarien sowie relevante Perspektiven (Patient, Hausarzt, Gesundheitssystem, Volkswirtschaft) werden dabei berücksichtigt sowie Sensitivitätsanalysen durchgeführt.
Ergebnisse In Europa werden jährlich fast 1,2 Milliarden Fälle leichterer Gesundheitsstörungen durch Selbstmedikation behandelt, wodurch 26,31 Milliarden Euro an direkten Kosten und 10,41 Milliarden Euro an indirekten Kosten eingespart werden (Status quo). Im Durchschnitt spart ein Euro, den die Verbraucher für rezeptfreie Arzneimittel ausgeben, den jeweiligen nationalen Gesundheitssystemen und Volkswirtschaften 6,70 EUR. Je nach Land könnten weitere 10–25% der derzeitigen Hausarztbesuche durch Selbstbehandlung substituiert werden, was ein zusätzliches Einsparpotenzial von 17,60 Mrd. EUR bedeuten würde.
Schlussfolgerung Die Studienergebnisse zeigen, dass die Selbstbehandlung leichterer Gesundheitsstörungen mit rezeptfreien Arzneimitteln in Europa bereits heute mit einem hohen ökonomischen und sozialen Nutzen für den Einzelnen und die Gesellschaft verbunden ist. Die gegenwärtigen Einsparungen können durch gesundheitspolitische Maßnahmen zur Förderung einer verantwortungsvollen Selbstmedikation noch weiter gesteigert werden. Hierdurch können weitere Ressourcen und Effizienzreserven für die Gesundheitssysteme und die Volkswirtschaften freigesetzt werden.
Die so zusätzlich freiwerdenden Ressourcen können dazu beitragen, die Gesundheitssysteme in Europa resilienter gegenüber aktuellen und künftigen wirtschaftlichen Herausforderungen auszugestalten.
Key words
self-care - self-medication - non-prescription medicine - public healthcare system - primary healthcare - decision-analytic model - minor ailment - EuropeSchlüsselwörter
Self-care - Selbstmedikation - rezeptfreie Arzneimittel - öffentliches Gesundheitssystem - primäre Gesundheitsversorgung - entscheidungsanalytisches Modell - leichtere Gesundheitsstörung - Europapublished online 2023Publikationsverlauf
Artikel online veröffentlicht:
22. Mai 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).
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