The demographic impact on ambulatory pharmaceutical expenditure in Belgium

It has become customary in our society to attribute the rise in health care expenditure to a large extent to the aging of the population. The Belgian Institute of Health Economics (BIGE-IBES) finalised a study to measure the impact of the demographic trend on public spending for ambulatory pharmaceuticals. The results show that the changes in age structure as such have a relatively small impact on health care expenditure. Over the period 1986-1996 an annual growth of +0.73% was observed, while total public spending showed an annual average increase of +6.2% (in constant francs 1996). This first static demographic impact will become +0.75% per year for the next decade 1996-2006. It is, however, possible to calculate the extent to which per capita expenditure envolved differently according to age group: over 1986-1996 expenditure for the elderly was rising more sharply than for the younger age groups. This leads to a second dynamic demographic impact which will cause an annual growth rate of +1.91% for the next decade, according to the working hypothesis put forward. This growth rate is to be compared with the authorized budgetary increase of +1.5% per year (inflation excluded), according to the EU-Maastricht quotes..., and it does even not take into account the other increasing factors as technological innovation and epidemiological needs.