Table 1

Summary of outpatient prescription drug coverage in study countries, 2016

CountryOutpatient prescription drug coverageDominant source of pharmaceutical financing (%)Standard patient charges for reimbursable prescriptionsChange in subsidy at age 65+
AustraliaUniversalPublic (49%)£21.91 (AU$38.30)Yes—lower copayment of £3.55 (AU$6.20)
CanadaNon-universalMixed financing*Varies by drug planEligible for public drug coverage in several provinces
FranceUniversalSocial insurance (70%)35–70% coinsuranceIndirect—coinsurance waved for chronic illness
GermanyUniversalSocial insurance (79%)£4.19–8.38 (€5–10) copaymentYes—copayment exemptions
NetherlandsUniversalSocial insurance (80%)NoneNo
New ZealandUniversalPublic (63%)£2.76 (NZ$5)Indirect—no copayments once household exceeds 20 prescriptions in year
NorwayUniversalPublic (57%)38% coinsuranceIndirect—annual patient contribution capped at £216 (kr2185)
SwedenUniversalPublic (52%)£96.67 (kr1100) annual deductible and 10–50% coinsuranceIndirect—annual patient contribution capped at £193.34 (kr2200)
SwitzerlandUniversalSocial insurance (65%)Annual deductible (chosen by patient with insurance plan) and 10% coinsuranceNo
UKUniversalPublic (66%)None in Scotland, Wales and Northern Ireland; £8.20 copayment in EnglandYes—copayment exemption in England
USANon-universalPrivate (36%)Varies by drug planYes—eligible for Medicare drug benefit
  • *Public payment, private insurance and out-of-pocket charges finance approximately equal shares of total pharmaceutical spending outside hospitals (30–34% each).

  • Sources: OECD Health Database and authors’ review of coverage system information provided by managers of public and statutory health systems in each country, June–August 2016.