Data extracted in October 2025
Planned article update: November 2026
Highlights
Current healthcare expenditure in the EU was €1 720 billion in 2023. This was equivalent to 10.0% of gross domestic product (GDP).
Among EU countries, Germany (11.7%), France (11.5%), Austria and Sweden (both 11.2%) had the highest current healthcare expenditure relative to GDP in 2023.
Among EU countries, the largest expansions (in percentage terms) in current healthcare expenditure per inhabitant between 2014 and 2023 were recorded in Romania, Bulgaria, Lithuania, Latvia, Poland, Czechia, Estonia and Croatia, where expenditure more than doubled.
Current healthcare expenditure relative to GDP, 2023
This article presents key statistics on expenditure aspects of healthcare in the European Union (EU). More detailed information is available – with analyses by functions, providers and financing schemes – in a separate article. Healthcare systems are organised and financed in various ways across EU countries, but universal access to quality healthcare, at an affordable cost to both individuals and society at large, is widely regarded as a basic right in the EU.
Statistics on healthcare expenditure and financing may be used to evaluate how a healthcare system responds to the challenge of universal access to quality healthcare, through measuring financial resources available for the healthcare sector and the allocation of these resources between healthcare activities (for example, preventive and curative care) or groups of healthcare providers (for example, hospitals and ambulatory centres).
This article forms part of an online publication on Health in the European Union – facts and figures.
It should be noted that the latest data presented in this article are for 2023. Therefore, the data in this article show the situation after the COVID-19 pandemic. For this reason, particular attention should be paid when comparing 2022 and 2023 data with data for 2020 to 2021 and when comparing data for 2020 and 2021 with earlier years.
Healthcare expenditure
Germany, France, Austria and Sweden had the highest current healthcare expenditure relative to GDP in 2023
Current healthcare expenditure in the EU was €1 720 billion in 2023. Germany had the highest level of current healthcare expenditure among EU countries, valued at €492 billion in 2023. France recorded the second highest level of current healthcare expenditure (€325 billion), followed by Italy (€179 billion) and Spain (€138 billion).
In 2023, current healthcare expenditure in the EU was equivalent to 10.0% of gross domestic product (GDP). Among the EU countries, Germany recorded the highest ratio, which was equivalent to 11.7% of GDP; the next highest ratios were in France (11.5%), Austria and Sweden (both 11.2%) – see Table 1. By contrast, current healthcare expenditure accounted for less than 7.0% of GDP in 4 EU countries: Luxembourg, Romania (both 5.7%), Hungary (6.4%) and Ireland (6.6%).
Relative to population size and in euro terms, current healthcare expenditure in 2023 was highest among EU countries in Luxembourg (€6 888 per inhabitant). It is interesting to note that Luxembourg had the highest ratio per inhabitant despite having the lowest ratio of healthcare expenditure to GDP, reflecting the high level of GDP in Luxembourg. A significant proportion of workers in Luxembourg are cross-border workers and live outside the country and, as non-residents, the expenditure on their healthcare is not included in Luxembourg’s health accounts while their economic activity contributes to Luxembourg’s GDP.
Following on from Luxembourg, the next highest ratios in 2023 were observed in Ireland, Denmark, Germany, the Netherlands, Austria and Sweden, all above €5 700 per inhabitant. In turn, these were followed by Belgium, Finland and France with ratios between €4 700 and €5 500 per inhabitant. There was then a relatively large gap to Malta, Italy, Spain, Slovenia, Cyprus, Portugal and Czechia with ratios above €2 400 but below €3 300 per inhabitant. All of the remaining 10 EU countries recorded average expenditure below €2 100 per inhabitant; 1 of these, Romania, recorded an average spend on healthcare below €1 000 per inhabitant. The ratio between the highest (Luxembourg) and lowest (Romania) levels of expenditure per inhabitant was 7.1 : 1.
The disparities in current healthcare expenditure per inhabitant are less apparent when expenditure is expressed in purchasing power standards (PPS). This measure adjusts for differences in price levels between EU countries. Germany (5 413 PPS per inhabitant), Austria (4 900 PPS per inhabitant) and the Netherlands (4 848 PPS per inhabitant) recorded the highest ratios of healthcare expenditure per inhabitant in PPS terms. Romania (1 776 PPS per inhabitant) had the lowest ratio. As such, by taking account of price level differences, the ratio between the highest (Germany) and lowest (Romania) levels of healthcare expenditure per inhabitant was considerably smaller than the equivalent ratio in euro terms mentioned above, as it was 3.0 : 1.
Developments over time
Table 2 and Figures 2 and 3 highlight developments in the level of healthcare expenditure and the level of healthcare expenditure relative to GDP in recent years, focusing on a comparison between 2014 and 2023. Note that the analyses in Table 2 and Figure 2 are presented in current price terms and so reflect price changes (inflation and deflation) as well as changes in real expenditure.
Based on the data shown in Table 2, all EU countries recorded higher healthcare expenditure in 2023 than in 2014. The largest overall increases were observed in Romania, Lithuania, Malta, Bulgaria, Estonia, Czechia, Latvia, Cyprus and Poland, where expenditure in 2023 was more than double that in 2014. The highest increase, in Romania, was 144.7%, equivalent to a compound annual average increase of 10.5%. The smallest increases between 2014 and 2023 were observed in Italy (up 23.6% overall) and Sweden (25.1%).
As well as being affected by price changes, comparisons of healthcare expenditure over time can also be influenced by demographic changes. Figure 2 shows the average healthcare expenditure per inhabitant in 2014 and 2023. All EU countries recorded a higher level of expenditure per inhabitant in 2023 than in 2014. As with the rate of change based on overall expenditure, Romania recorded the largest increase, with average expenditure per inhabitant increasing by 155.6%; in Bulgaria, Lithuania, Latvia, Poland, Czechia, Estonia and Croatia, this ratio also at least doubled. The smallest increase was observed in Sweden, up 15.2%.
_HCE2025.png)
Source: Eurostat (hlth_sha11_hf)
Figure 3 provides another analysis of the change in overall healthcare expenditure between 2014 and 2023, focusing on the ratio between this expenditure and GDP. Healthcare expenditure and GDP are both influenced by price changes and so, when combining the 2 indicators in a ratio, the impact of inflation may cancel out to some degree: this depends on the extent to which the price changes related to healthcare expenditure are similar to those experienced in the economy as a whole.
There were 7 EU countries that reported a lower ratio of healthcare expenditure to GDP in 2023 than in 2014. Ireland recorded the largest decrease, down 2.7 percentage points, its share falling from 9.2% in 2014 to 6.6% in 2023, in part reflecting a large increase in Irish GDP between these years. The 6 other decreases were smaller than 1.0 points. In EU countries where the ratio was higher in 2023 than it had been in 2014, the increase was not more than 1.2 percentage points in most cases. A larger increase was observed in Latvia, up 1.6 points.
_HCE2025.png)
Source: Eurostat (hlth_sha11_hf)
Source data for tables and graphs
Data sources
The 2023 data for the EU, Malta and Finland are provisional, as are the 2022 data for Norway.
Tables in this article use the following notation
- A colon ':' is used to show where data are not available.
Current healthcare expenditure
Current healthcare expenditure quantifies the economic resources dedicated to health functions, excluding capital investment. Current healthcare expenditure is primarily concerned with healthcare goods and services that are consumed by resident units, irrespective of where that consumption takes place (it may be in the rest of the world) or who is paying for it. As such, exports of healthcare goods and services (to non-resident units) are excluded, whereas imports of healthcare goods and services for final use are included.
System of health accounts – methodology
Eurostat, the Organisation for Economic Co-operation and Development (OECD) and the World Health Organization (WHO) established a common framework for a joint healthcare data collection exercise. The data collected relates to healthcare expenditure following the methodology of the system of health accounts (SHA).
The SHA shares the goals of the system of national accounts (SNA): to constitute an integrated system of comprehensive, internally consistent and internationally comparable accounts, which should as far as possible be compatible with other aggregated economic and social statistical systems. Health accounts provide a description of the monetary flows related to final consumption expenditure on healthcare goods and services. Health accounts are used in 2 main ways: internationally, where the emphasis is on a selection of comparable expenditure data; nationally, with more detailed analyses of healthcare spending and a greater emphasis on comparisons over time.
For more details on health accounts, see A system of health accounts, 2011 – revised edition. The core set of SHA tables addresses 3 basic questions: i) what kinds of healthcare goods and services are consumed, ii) which healthcare providers deliver them and, iii) which financing schemes are used to finance the expenditure?
Healthcare expenditure – legal basis
Commission Regulation (EU) 2021/1901 of 29 October 2021 as regards statistics on health care expenditure and financing is the legal basis for data collection according to SHA 2011 methodology for healthcare expenditure. Commission Regulation (EU) 2015/359 of 4 March 2015 implementing Regulation (EC) No 1338/2008 as regards statistics on healthcare expenditure and financing applied to data from reference year 2014 to 2020.
Statistics on healthcare expenditure are documented in a background article which provides more information on the scope of the data, the legal framework, the methodology employed, as well as related concepts and definitions.
Context
Health systems across the globe are developing in response to a multitude of factors, including new medical technology and improvements in knowledge providing new health services and a greater access to them; changes in health policies to address specific diseases and demographic developments; new organisational structures and more complex financing mechanisms. However, access to healthcare and greater patient choice is increasingly being considered against a background of financial sustainability.
Within the European Commission, the Directorate-General for Health and Food Safety and the Directorate-General for Employment, Social Affairs and Inclusion are responsible for policy actions on health.
Regulation (EU) 2021/522 establishing a Programme for the Union’s action in the field of health (‘EU4health programme’) for the period 2021 to 2027 provides funding to EU countries, health organisations and non-governmental organisations (NGOs).
In May 2024, the European Commission summarised work done and progress made within the health domain through a communication The European Health Union: acting together for people’s health (COM(2024) 206 final). It highlights a range of actions designed to make people’s lives safer and healthier.
The Directorate-General for Health and Food Safety has constituted a list of 88 European core health indicators (ECHIs) for monitoring progress in relation to health policy and broader objectives. Among these, it specifically recommends following developments on:
- expenditure on healthcare as a percentage of GDP
- expenditures on healthcare in purchasing power standards (PPS).
Explore further
Other articles
Online publication
Methodology
Healthcare expenditure statistics articles
- Healthcare expenditure statistics by function, provider and financing scheme
- Preventive health care expenditure statistics
General health statistics articles
Database
- Health (hlth), see:
- Health care (hlth_care)
- Health care expenditure (SHA 2011) (hlth_sha11)
Thematic section
Methodology
- A system of health accounts 2011 – revised edition
- Healthcare expenditure (SHA 2011) (ESMS metadata file – hlth_sha11_esms)
Legislation
Implementing legislation
- Commission Regulation (EU) 2015/359 of 4 March 2015 as regards statistics on healthcare expenditure and financing (up to and including the 2020 reference year)
- Commission Regulation (EU) 2021/1901 of 29 October 2021 as regards statistics on healthcare expenditure and financing (first reference year starting from 2021)