In 2021, spending on retail pharmaceuticals (that is, excluding those used during hospital stays and in other health facilities) accounted for one-sixth of overall healthcare expenditure on average across OECD countries. Over the last two decades, it has increased at a slower pace when compared with other areas, such as inpatient and outpatient care.

There were, however, large differences across countries. Spending in the United States was more than double the OECD average, while the majority of OECD countries fell within a relatively narrow spending band of ±20% from the average. Per capita spending was lowest in Denmark where a higher proportion of medicine spending is accounted for as part of inpatient or outpatient treatments.

Across 26 OECD countries, the pharmaceutical industry received USD 11.5 billion in external funding for R&D in 2019 (or the latest year with available data), representing just under 10% of total pharmaceutical R&D spending. This includes domestic funding by government, higher education, and private non-profit sectors as well as funding from foreign sources. R&D subsidies for the industry in the United States alone accounted for 73% of the OECD total, similar to the US share of total R&D expenditure.

The share of R&D in the pharmaceutical industry that was funded by external sources varied considerably between countries. Subsidies accounted for 1% of R&D expenditure in Japan and 2% in Switzerland, whereas the share was 20% Germany, and as much as 49% in the United Kingdom.

The amount of antibiotics prescribed varies greatly across OECD countries, with Greece and France showing the highest rate of consumption with 19 and 22 defined daily doses per 1,000 people per day. Various reasons can explain the differences of antibiotic consumption, such as stricter primary healthcare prescribing guidelines and incentives, or differences in patients’ attitudes towards treatment for infectious illnesses. All OECD countries with available data reported reductions in antibiotic prescribing in 2021. This decrease was probably associated with fewer cases of infectious diseases during the COVID-19 pandemic, thanks to confinement measures and better hygiene practices. Excessive antibiotic consumption can be a cause for concern due to the threat of antimicrobial resistance.