german pharmacies (figures, data, facts) 2012
DESCRIPTION
Figures, data and facts about pharmacies in Germany (2012)TRANSCRIPT
german pharmacies figuresdatafacts2012
2
01 Pharmacy image .......................................................................... 3
02 Pharmacy services ....................................................................... 4
03 Emergency service and formulations ........................................... 5
04 Numbers of pharmacies ............................................................... 6
05 Pharmacies in the German states ................................................ 7
06 Trends in the number of jobs in community pharmacies .........8 – 9
07 Pharmacists and pharmacy students ........................................ 10
08 Pharmacy and trainee position ................................................... 11
09 Pharmacy density in Europe ...................................................... 12
10 Pharmacy remuneration by comparison .................................... 13
11 SHI expenditure on pharmaceuticals (excl. co-payments) ........ 14
12 Distribution of the value added .................................................. 15
13 Allocation of total SHI expenditure .......................................16 – 17
14 Distribution miscellaneous costs ................................................ 18
15 Vaccine sales .............................................................................. 19
16 Statutory pharmacy and manufacturer rebates ......................... 20
17 Rebated pharmaceuticals .......................................................... 21
18 Co-payments for pharmaceuticals ............................................. 22
19 Co-pay exemptions .................................................................... 23
20 Prescribed pharmaceuticals (SHI) ............................................. 24
21 Pharmaceutical expenditure per person .................................... 25
22 Distribution of pharmacies according to turnover .................26–27
23 Structure of pharmacy sales .................................................28–29
24 Structure of complementary product range ............................... 30
25 Drug-related problems (DRP) concerning self-medication ........ 31
26 VAT on pharmaceuticals in the EU ........................................32–33
Contents
3
82 %
86 %
87 %
93 %
72 %
of Germans feel that pharmacies providegood-quality service, and consider them to be some of the best service providers in Germany4
of Germans judge the night and emergency service as an important part of their health care3
of Germans have a high degree of trust in pharmacists2
of Germans consider owner-run pharmacies as indispensable in urgent cases 1
of Germans go to the pharmacy first when they have minor health issues5
is the mark Germans give to owner-run pharmacies concerning healthcare of their children5
1.8
Sources (representative surveys)1 Institut für Handelsforschung, Köln 20122 Reader's Digest 20113 Forsa 20134 Allensbach 20085 IFAK-Institut 20115 infas 2009
01Pharmacy image
4
Services 2012
4 million patient contacts per day 250,000 home deliveries per day 500,000 emergency services per year 15 million extemporaneously prepared formulations,
which are covered by the statutory health insurance 2,500 training courses offered by the Chambers of Pharmacists 129,000 participants of those training courses
02 Pharmacy services
Packaging defect
(Suspected) adverse drug reactions (side effects; including suspected misuse or abuse of drugs)
Quality product defects
Mechanical failures (product defect)
Mislabelling (product defect)
Other product defects
8,500 Reports of suspected drug safety concerns to the Drug Commission of German Pharmacists (AMK)
26 %
4 %
24 %
26 %
12 %
8 %
5
Night and emergency service
1,400 pharmacies per night 20,000 patients per night and emergency service 7 million packs provided outside the regular opening hours Especially important for children (and their parents): above-
average percentage of SHI* pharmaceuticals dispensed during night and emergency service is prescribed by paediatricians.
1 million requests via the internet and apps along with telephone calls and text messages to the mobile pharmacy emergency hotline 22 8 33
1.8 million online queries per year via the official web portal of German pharmacists www.aponet.de
Formulations
15 million extemporaneously prepared formulations per year, which are covered by the statutory health insurance
21 percent of which are methadone, 14 percent cytostatic and 6 percent parenteral preparations
1 million extemporaneously prepared formulations per year exclu-sively for children and covered by the statutory health insurance
Emergency service and formulations 03
* SHI – Statutory Health Insurance
6
Figures as at year-end
04 Numbers of pharmacies
2004 2005 2006 2007 2008 2009 2010 2011 2012
21,39221,476
21,551 21,570 21,602 21,54821,441
21,238
20,921
Number of pharmacies (incl. subsidiaries)
Subsidiaries
Pharmacies opened
Pharmacies closed
2004 2005 2006 2007 2008 2009 2010 2011 2012
6321,228
1,7962,356
2,8513,224 3,478 3,661 3,853
343326 346 370 360 298
263221
184
2004 2005 2006 2007 2008 2009 2010 2011 2012
2004 2005 2006 2007 2008 2009 2010 2011 2012
256 242 271351 328 352 370
424501
7
Figures as at year-end; * Pharmacies with operating licence in accordancewith § 2 of the Apothekengesetz (pharmacy regulations)
German State
Public pharmacies
in 2012
Independent pharmacies*
Subsidiaries
Baden-Württemberg 2,670 2,168 502
Bavaria 3,347 2,733 614
Berlin 861 709 152
Brandenburg 573 450 123
Bremen 155 121 34
Hamburg 436 353 83
Hesse 1,569 1,283 286
Mecklenburg-West Pomerania 409 333 76
Lower Saxony 2,041 1,661 380
North Rhine 2,425 2,001 424
Westphalia-Lippe 2,127 1,717 410
Rhineland-Palatinate 1,084 918 166
Saarland 323 282 41
Saxony 999 791 208
Saxony-Anhalt 617 496 121
Schleswig-Holstein 712 596 116
Thuringia 573 456 177
Total 20,921 17,068 3,853
Pharmacies in the German states 05
98
Year-end 2004 2005 2006 2007 2008 2009 2010 2011 2012
Pharmacists 46,014 46,276 46,953 47,766 48,030 48,002 48,695 48,690 48,422
Of which female (%) 65.5 64.8 66.0 66.6 68.5 69.2 68.7 69.9 70.2
Pre-registration traineepharmacists
1,431 1,534 1,518 1,506 1,327 1,287 1,367 1,442 1,462
Pharmaceutical engineers 9,602 9,266 8,292 8,413 8,196 8,056 7,701 7,570 7,193
Pharmaceutical technicalassistants (PTA)
43,946 46,431 48,656 49,874 51,907 53,734 55,345 56,987 58,368
Pharmaceutical commercialemployees (PCE) / other
35,812 36,454 38,355 36,026 36,020 35,769 34,719 33,915 33,269
Total jobs 136,805 139,961 143,774 143,585 145,480 146,848 147,827 148,604 148,714
06 Trends in the numberof jobs in communitypharmacies
10
07 Pharmacists and pharmacy students
Pharmacists in: 2011 2012Percentage
of women
Community pharmacies 48,690 48,422 70.2
Of which managers 17,577 17,068 46.2
Hospital pharmacies 1,966 2,034 65.0
Industry, administration,organisation, science 8,635 9,283 58.4
Pharmaceutical industry 4,602 5,079 57.5
Scientific institutions 280 280 64.6
Armed Forces 224 221 32.1
Authorities and associations 835 875 61.1
Universities 1,314 1,336 54.4
Educational institutions 480 490 76.3
Others 900 1,002 61.1
Total employedpharmacists 59,291 59,739 68.2
Pharmacists
Pharmacy students
2011/2012 13,603
2010/2011 12,719
2009/2010 12,485
2008/2009 12,052
2007/2008 11,721
11
Pharmacy trainee positions
PCEs in training
Pre-registration trainee pharmacists
PTA trainees
08
Total number of trainee positions
4,244
2,451
1,462
8,157
12
People per pharmacy*
09 Pharmacy density in Europe
Denmark 17,700
Slovenia 6,600
Luxembourg 5,500
United Kingdom 4,600
Czech Republic 4,000
Estonia 2,800
Romania 3,100
Hungary 4,000
Germany 3,900
Portugal 3,700
Italy 3,400
EU-average 3,200
Slovakia 2,800
Latvia 2,700
Lithuania 2,200
Spain 2,200
Belgium 2,100
Malta 2,000
Greece 1,000
Bulgaria 1,800
Cyprus 1,900
Netherlands 8,300
Sweden 7,600
Austria 6,500
France 2.800
Croatia** 4,100
Ireland 2,600
Finland 6,600
Poland 3,400
* Germany: ABDA-Statistik 2012; all other countries: last available year according to ZAEU, SFK, IPU, ÖAK, AFP, SPA** Accession to the EU 1st July 2013
13
Pharmacy remuneration by comparison 10
Total SHI income
Gross domestic product
Standard wages (ADEXA)
Inflation rate
Total gross profit per prescribed unit
Index (2004 = 100) * Provisional, based on projection
110.7
116.4
123.3
137.6
118.0
125
95
110
100
2004 2005 2006 2007 2008 2009 2010 2011 2013*2012
14
in EUR bn
Total amount spent by SHI on pharmaceuticals in 2012
11 SHI expenditure on pharma ceuticals (excl. co-payments)
Pharmaceutical industry and purchased materials and services (such as raw materials)
Pharmaceutical wholesalers
VAT (exchequer)
Pharmacies
4.21 (=15.2 %)
4.43 (=16.0 %)
1.03 (=3.7 %)
18.04(=65.1 %)
27.71 (=100 %)
15
Every EUR 100 spent by SHI on pharmaceuticals is allocated as follows:
* Taking into account the statutory pharmacy rebate of EUR 1.75
Distribution of the value added 12
2012
2011
2010*
2009*
2008
2007
Pharma-cies
Whole-salers
Industry Exchequer (VAT)
0 % 20 % 40 % 60 % 80 % 100 %
15.2 3.7 65.1 16.0
15.4 3.6 65.0 16.0
15.6 4.0 64.4 16.0
15.7 3.9 64.4 16.0
15.5 4.0 64.5 16.0
15.9 4.1 64.0 16.0
1716
13 Allocation of totalSHI expenditure
* Provisional** Taking into account the statutory pharmacy rebate of EUR 1.75*** From pharmacies
Of w
hich
is a
lloca
ted
to
pha
rmac
ies
bas
ed o
n th
e D
rug
Pric
e O
rdin
ance
(Arz
neim
ittel
pre
isve
rord
nung
)
Pha
rmac
eutic
als*
**
Total SHI expenditure (in EUR bn) M
isc.
co
sts
Ad
min
istr
ativ
e ex
pen
ditu
re
Rem
edie
s an
d th
erap
eutic
aid
s
Den
ture
s
Den
tists
Do
cto
rs
Of
wh
ich
(%
)
Ho
spita
ls
20065.2 16.834.01.8
148.0915.0 5.6 5.5 16.1 2.7
20045.4 16.633.92.6
140.185.915.3 5.8 14.5 2.5
2010**4.7 18.033.31.8
175.9915.1 5.6 5.4 16.1 2.5
2011
2012*
4.7 18.433.61.8179.61
15.1 5.9 5.3 15.2 2.3
4.7 18.733.71.7184.52
15.1 5.9 5.2 15.0 2.3
20075.1 17.533.01.8
154.0215.0 5.6 5.3 16.6 2.6
20085.0 32.71.8
160.9415.0 5.7 5.1 18.2 16.6 2.6
2009**4.8 32.71.8
171.0815.1 5.6 5.2 18.2 16.6 2.6
20055.2 16.334.01.7
143.9215.0 5.8 5.7 16.4 2.8
18
14 Distribution ofmiscellaneous costs
Sick pay 5.0
Transportation expenses 2.2
Home care 2.1
Pharmaceuticals from others 1.5
Ambulant & inpatient treatment, rehab 1.3
Early diagnosis measures 1.1
Dialysis in doctors` practices 1.0
Social services 0.9
Integrated care 0.8
Pregnancy, maternity 0.6
Services abroad 0.5
Others 1.7
Total 18.7
in %
19
In 2007, vaccinations were included in the SHI catalogue of required services.
* Provisional
Vaccine sales
in EUR m (incl. VAT)
Of which tick-borne meningoencephalitis
Of which flu
Of which pneumococcus
Of which human papillomavirus (HPV)
15
2012*
131 187 139 97
2011
139 230 146 77
2010
125 275 141 57
2009
171 335 149 90
2008
266 285 153 216
2007
300 241 170 133
2006
140 182 84
1,176
1,257
1,021
932
1,033
1,349
799
20
16 Statutory pharmacy and manufacturer rebates
* Provisional, taking into account the statutory pharmacy rebate of EUR 1.75
Pharmacy rebate
Manufacturer rebates (excl. rebate contracts)
Wholesale rebate (only prescriptions)
in EUR m
2010* 2011 2012
1,211
2,312
1,032
1,477
2,285
1,208
147
21
18,400 Number of rebate contracts
144 Involved health insurance companies
161 Involved pharmaceutical manufacturers
29,200 Number of rebated pharmaceuticals (Central Pharmaceutical Number)
42 % Share of rebated pharmaceuticals subject to no or reduced co-payments
354 m Rebated packs of generic pharmaceuticals
13.3 mNumber of data sets that need to be pro-cessed by Pharmacy IT
Rebatedpharmaceuticals
Figures as at year-end 2012
17
22
18 Co-payments for pharmaceuticals
Co-payments in EUR m
Average charge per unit in EUR
1,862
20122007
1,626
2008
1,674
2009
1,696
2010
1,767
2011
1,833
2.60
2012
2.30
2007
2.30
2008
2.30
2009
2.40
2010
2.50
2011
23
Co-pay exemptions
Number of patients who exceed the annual prescription charge limit of 1 % of their gross annual income (chronically ill patients):
2004 2011
5,969,8056,938,274
Number of patients who exceed the annual prescription char-ge limit of 2 % of their gross annual income:
2004 2011
508,359
673,557
Number of patients who are exempt from the prescription charge (hardship cases in accordance with § 62 SGB V):
2004 2011
7,446,6336,643,362
19
24
Note: modified method of counting medical devices
20 Prescribedpharmaceuticals (SHI)
Prescriptions per member
Pharmaceu-ticals per
prescription
Prescribed pharmaceu-
ticals per member
2012 8.73 x 1.59 = 13.88
2011 8.89 x 1.60 = 14.22
2010 8.84 x 1.62 = 14.32
2009 8.79 x 1.64 = 14.42
2008 8.81 x 1.64 = 14.45
2007 8.66 x 1.63 = 14.12
25
Pharmaceutical expenditure per person
Incl. VAT
21Pharmaceutical expenditure per person
Over-the-counterpharmaceuticalsEUR 52
Prescription phar-maceuticalsEUR 509
TotalEUR 561
2726
Pharmacy share according to turnover (%)
Turnover in EUR m (excl. VAT)
Distribution of pharmacies according to turnover22
7.0
<0.
75
9.6
<1.
00
13.6
15.1
<1.
25
<1.
50
12.0
<1.
75
11.2
<2.
00
1.4<
3.75
8.7
<2.
25
1.0<
4.00
5.1
<2.
50
0.7
<4.
25
4.9
<2.
75
0.5
<4.
50
3.3
<3.
00
0.3
<4.
75
2.2
<3.
25
0.4
<5.
00
1.6
>3.
50
1.4
>5.
00
2928
1) Supplymentary assortment2) Patient care products3) Unrestricted OTC pharmaceuticals
23 Structure ofpharmacy sales
Measured in sales value:
Pharmacy sales in 2012 (excl.VAT) EUR 42.6 bn = 100 %
Pharmaceuticals EUR 38.6 bn = 90.6 %
1)EUR2.3 bn= 5.4 %
2)EUR1.7bn = 4.0 %
Value of pharmaceuticals covered by SHI, private insurance or other
EUR 35.0 bn = 82.1 %
Self-medication
EUR 3.6 bn= 8.5 %
Prescriptionpharmaceuticals
EUR 34.1 bn =80.0 %
Pharmacy-only pharmaceuticals (non-prescription)
EUR 4.2 bn =9.9 %
3)EUR0.3 bn = 0.7 %
Not prescribed
EUR3.3 bn = 7.8 %
Pre-scribed
EUR0.9 bn= 2.1 %
Measured per units:
Prescriptions 2012 1,355 m units = 100 %
Prescription pharmaceuticals
722 m units =53.3 %
Prescribed
102 m units= 7.5 %
Not pre-scribed
486 m units= 35.9 %
Volume of pharmaceuticals covered by SHI,private insurance and other
824 m units = 60.8 %
Self-medication
531 m units = 39.2 %
1)
45 m = 3.3 %
Pharmacy-onlypharmaceuticals(non-prescription)
588 m units =43.4 %
Note: modified database for prescription pharmaceuticals, therefore not fully comparable with previous years.
1) Unrestricted OTC pharmaceuticals*
* Pharmaceuticals which may be sold outside pharmacies (e.g. by chemists)
30
Supplementaryassortment (2.3)
Patient careproducts (1.7)
Sales in EUR bn (excl. VAT)
24 Structure of complemen-tary product range
Medical products and therapeutic aids
Hygienic and cosmetic products
Vitamins and minerals
Other
0.3
(1.2)
1.4
0.8
1.4
4.0 Total
(0.3)
31
Findings of the study: Nature and frequency of drug-related problems in daily community pharmacy practice in Germany.
Almost every 5th patient request for self-medication phar- maceuticals was associated with one or more drug-related problems (DRP).
72 % of DRP occured in conjunction with the four most common indications, i.e. pain, respiratory-, gastrointestinal- and skin disorders.
75 % of DRP were inappropriate self-medication, inapprop-riate product request, wrong dosage, and duration of drug use (including abuse) was too long.
If a patient had a medication record at the pharmacy, significantly more cases of wrong dosage and drug-drug interactions could be identified.
90 % of DRP could be resolved in pharmacies.
Source: Eickhoff C, Hämmerlein A, Griese N, Schulz, M.: Nature and frequency of drug-related problems in self-medication (over-the counter drugs) in daily community pharmacy practice in Germany. Pharmacoepidemiol. Drug Saf. 2012; 21 (3); 254-260
Drug-related problems (DRP) concerningself-medication
25
3332
26 VAT on pharmaceuticals in the EU*
General VAT rate
General VAT rate
Tax rate for pharmaceuticals
Tax rate for pharmaceuticals
Denmark 25.0 25.0
Germany 19.0 19.0
Bulgaria 20.0 20.0
Czech Republic 15.0 21.0
Latvia 12.0 21.0
Italy 10.0 21.0
Austria 10.0 20.0
Slovakia 10.0 20.0
Estonia 9.0 20.0
Slovenia 8.5 20.0
Poland 8.0 23.0
Belgien 6.0 21.0
Greece 6.5 23.0
Portugal 6.0 23.0
Netherlands 6.0 21.0
Romania9.0
24.0
24.0Prescription pharmaceuticals
Over-the-counter pharmaceuticals
Finland 10.0 24.0
Hungary 5.0 27.0
Cyprus 5.0 18.0
Spain 4.0 21.0
Luxembourg 3.0 15.0
Malta 0.0 18.0
Sweden0.0
25.0
25.0Prescription pharmaceuticals
Over-the-counter pharmaceuticals
Ireland0.0
23.0
23.0Oral medication
Non-oral medication
UK0.0
20.0
20.0National Health Servicepharmaceuticals
Over-the-counter pharmaceuticals
Croatia**5.0
25.0
25.0National Health Servicepharmaceuticals
Over-the-counter pharmaceuticals
Lithuania 5.0
21.0
21.0Refundable pharmaceuticals
Non-refundable pharmaceuticals
France 2.1
7.0
19.6Refundable pharmaceuticals
Non-refundable pharmaceuticals
* Tax rates as at 2013** Accession to the EU 1st July 2013
34
Notes
35
Legal disclosure:
Published by the ABDA – Federal Union of German Associations of PharmacistsJägerstr. 49/5010117 BerlinGermanywww.abda.de
Print:
Liskow Druck und Verlag GmbHwww.liskow.de
Sources:
ABDA-StatistikBundesministerium für GesundheitEuropäische KommissionForsa Gesellschaft für Sozialforschung und statistische Analyse mbHIFAK-InstitutIMS HEALTH GmbH & Co. OHGinfas Institut für angewandte Sozialwissenschaft GmbHInstitut für Demoskopie AllensbachInstitut für Handelsforschung, KölnIrish Pharmacy Union (IPU)Österreichische Apothekerkammer (ÖAK)Pro Generika e.V.Reader's Digest Stichting Farmaceutische Kengetallen (SFK)Statistisches BundesamtThe Nielsen Company GmbHVerein Deutsches Arzneiprüfungsinstitut e.V.Zentrum für Arzneimittelinformation und Pharmazeutische Praxis (ZAPP)Zusammenschluss der Apotheker in der Europäischen Union (ZAEU)