Spending on health has started to rise again after stagnating or even falling in many member nations of the Organisation for Economic Cooperation and Development (OECD), but the pace of growth remains well below pre-crisis rates, the OECD reports.

Within Europe, health expenditures continued to fall in 2012 in Greece, Italy, Portugal and Spain, as well as in the Czech Republic and Hungary, according to the 2014 edition of OECD Health Statistics. And in Greece, health spending in real terms was down 25% on 2009, primarily driven by cuts in public expenditures.

In contrast, beyond Europe 2012 saw some strong growth in health spending. Chile’s spend increased 6.5% while in Mexico growth was 8.5%, largely due to further efforts towards universal coverage and access to healthcare. And in Korea, spending has continued to grow 6% a year since 2009, mainly driven by increases in private expenditures.

In the US, spending was up 2.1% in 2012, which is above the OECD average but similar to growth rates seen in 2010 and 2011. 

The report also finds that overall health spending accounted for an average of 9.3% of Gross Domestic Product (GDP) across OECD countries in 2012, showing little change from 2011’s figure of 9.2% but a notable increase from the 8.6% level reported before the crisis. Health expenditures in the UK accounted for 9.3% of GDP, exactly the OECD average.

While spending on hospital and outpatient care grew in many countries during 2012, almost two-thirds of OECD nations have experienced real falls in pharmaceutical spending since 2009, the study notes. Reductions have been driven by price cuts, often through negotiations with manufacturers, and the growing market share taken by generic drugs, which has increased as a result of patent expiries for a number of high-volume, high-cost brand-name drugs, and also due to policies adopted to promote the use of cheaper generics.

The share of the market represented by generics grew an average of 20% between 2008 and 2012, to account for 24% of total pharma spending in the latter year, and with particularly sharp increases reported for Spain (+100%), France (+60%), Denmark (+44%) and the UK (+28%).

The study also puts the UK at 26th place out of 33 OECD nations in terms of pharmaceutical expenditure in 2012, and in 24th place for drug spending as a percentage of GDP.