North Macedonia

Republic of North Macedonia is located in Southeast Europe, in the central part of the Balkan Peninsula. It has a position of a strategic crossroad and belongs to the group of countries from the so-called Western Balkans. It is surrounded by the following neighbours - Serbia and Kosovo to the north, Bulgaria to the east, Greece to the south, and Albania to the west. North Macedonia gained independence from the Yugoslav Federation only in 1991; however, it is one of the oldest European countries – through the centuries being part of the Roman, Byzantine and Ottoman Empires. The capital of North Macedonia is Skopje.

Healthcare budget

$4.3 billion


2.1 million

GDP per capita



MKD (1 MKD = 0,016 euro)

World Ranking

GDP 134th

Statistics as April 21st 2021

North Macedonian healthcare

The country inherited a well-developed healthcare infrastructure after gaining independence in 1991 with good level of public healthcare services. Private hospitals were opened and primary care was privatised. Subsequently both public and private providers have been integrated into one social insurance-funded model managed by the Health Insurance Fund of North Macedonia. Healthcare expenditures represent 6.5% of GDP.

According to the Euro health consumer index the Macedonian healthcare system made the most remarkable advance of any country in the history of their Index, progressing from 27th to 16th place in 2014, due to implementation of a real time e-Booking system.

North Macedonian pharmaceutical environment

The government and National Agency for Drugs and Medical Devices is investing significant efforts into aligning the pharmaceutical legislation with EU standards. The Ministry of Health has set five core policy areas to improve: healthcare expenditures, healthcare revenues, payment mechanisms, information systems, and advocacy and public awareness strategies.

Positive attributes of North Macedonia’s healthcare and pharmaceutical market include improving government commitment to the provision of medical services through healthcare reforms. On the other side the budget for medicines remains quite restrictive.

Todays challenges

Average life expectancy at birth is 76 years (2019), still significantly below the EU-27 average (81 years). This is mainly caused by limited access to modern healthcare in rural parts of the country as well as by lower level of investments into healthcare (only 6.6% of relatively low GDP). Therefore the healthcare budget is under significant pressure due to ageing population and increasing demand for innovative medicines.

The expert in North Macedonia

Jiri Hermanek

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