Slovakia has been a member of the European union since 2004, the Euro zone since 2009, and the Schengen zone since 2007. Slovakia is a parliamentary democratic republic with a head of government, the prime minister who holds the most executive power, a head of state, the president who is the formal head of the executive, but with very limited powers. The country is subdivided into 8 regions, each named after its principal city. These have been given a certain degree of autonomy since 2002. The general health of the Slovak population has increased substantially over the last 15 years and the healthcare sector has undergone major reforms. Most indicators of population health status remain below the EU average, and substantial disparities in population health outcomes persist across ethnic and socioeconomic groups. In addition, and despite current low levels of expenditure, the healthcare sector faces long-term fiscal sustainability challenges, which will require continuing improvements to its efficiency. The official language is Slovak.---
GDP per capita
Three health insurance companies (one public and two private ones) operate the compulsory healthcare system in Slovakia, setting up contracts with health providers and negotiating quality, prices, and volumes individually. The Health Care Surveillance Authority serves as an independent monitoring body for the health provision, insurance and purchasing markets. The Ministry of Health functions as the main regulatory body within the health system. It is also the single shareholder of the biggest health insurance company (VšZP), covering a little over 60 % of the population. Risk equalisation has been implemented to redistribute health insurance company revenues to compensate for socioeconomic, demographic, and general health status differences among those insured.
Slovakia spends much less on health than the EU average, both in absolute terms (EUR 1 600 per person in 2017) and as a share of GDP (6.7%) which is a much lower share than the EU average of 9.8%. Around 80% of healthcare expenditure is publicly funded, which is like the EU average of 79%. Overall, the healthcare system remains very hospital-centric, with a limited role for primary care. Most healthcare spending is publicly financed (80% in 2017).
Slovakia has a developed and established EUR 1.25 billion Rx market. Spending on pharmaceuticals is above the EU average, which is a sign that the sector could be better regulated, and that controlling the high level of spending on pharmaceuticals has been a longstanding challenge in Slovakia.
Any drug applying for reimbursement can only be reimbursed if there is an EU reference price (at least one within EU28). The reference price is the average of the three lowest ex-factory prices with the exchange rate being set by an average over the last 12 months. Application for reimbursement is conditioned by existence of officially set prices of that medicine in at least 5 different EU member states, otherwise reimbursement is set at the level of 80% of final pharmacy price.
Since introduction of a shortened reimbursement process for rare disease medicines (1st January 2018), several such medicines received reimbursement approval.
Life expectancy at birth was 77.3 years in 2017, four years more than in 2000, but still nearly four years below the EU average (80.9 years). Slovak women live about seven years longer than men. Life expectancy of men and women at age 65 has increased substantially since 2000, but many years of life after that age are spent with chronic diseases and disabilities.
Tobacco consumption is a major public health concern - in 2014, almost one-quarter of the adult Slovak population smoked daily, and this proportion has not decreased during the last decade which contrasts with nearly all other EU countries. One in seven adults were obese in 2017, a rate close to the EU average with being overweight and obese among adolescents on the rise.
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