The revenue (value added) generated by health-related activities increased 8.9%, between 2005 and 2007 in Brazil. The level of participation of this sector in the Brazilian economy changed 5.5%, in 2005, to 6.0% (R$ 137.9 billion) in 2007. Out of this overall figure, R$ 48 billion corresponded to Public Health Services, including federal university hospital and military health units.

The consumption by health-related goods and services, in 2007, represented 8.4% of GDP. Household expenditure on goods and services reached R$ 128.9 billion (4.8% of GDP), out of which R$ 69 billion referred to expenditure on health-related services R$ 45 billion on medicines. General government expenditure on health-related activities changed from 3.3% to 3.5% of GDP between 2005 and 2007.

Health-related activities were responsible, in 2007, for 4.2 million job posts in the country (4.4% of the overall economy). In the same year, the average annual income of workers (by type of occupation) in these activities was R$ 20.5 thousand. These are some of the highlights of the Health Satellite Account, which organizes information concerning health-related economic activities, in the period 2005-2007.

Between 2005 and 2007, the revenue generated by activities of the health sector increased 8.9%, whereas the increase of overall Brazilian revenue was 9.7%. Public Health Services, including federal university hospital and military health units represented 34.8% of this overall figure. Private services accounted for 32.4% of it.

Gross value added (revenue generation) of health-related activities was R$ 119.0 billion, in 2006, and R$ 137.9 billion, in 2007. However, this change in value added from one year to another reflects both increases in quantity and quality of products (volume change) and in prices as well. Considering value added of health-related activities in 2007, volume change was 4.4%.

Medicines for human use concentrated imports in the field of health activities

Between 2005 and 2007, imports of goods and services of the health sector increased, in percent figures, at a higher rata than exports. Such increase was also bigger in terms of current values, considering the price rise of imported and exported products and the higher total initial value of imports.

In 2007, imports of goods and services amounted to R$ 11.6 billion and were mainly concentrated on medicines for human use (R$ 5.7 billion), appliances and instruments for medical, hospital and dental care use (R$ 2.7 billion) and pharmaceutical and chemical products (R$ 2.1 billion). Imports of this sector represented 3.7% of the total Brazilian exports, which reached R$ 315.3 billion in 2007.

Exports of the sector corresponded to less than less than one fifth of the value of imports, amounting to R$ 2.2 billion. The main highlight were exports of Medicines for human use, equivalent to R$ 817 million. In relation to total exports of the country, exports of goods and services represented 0.6%.

By dividing the value of imports by the total supplied by national economy (for each product), it is possible to obtain the participation of imports in the overall supply. This level of participation is especially high for pharmaceutical and chemical products – inputs used in the production of medicines. In 2007, 82.5% of supply of pharmaceutical and chemical products was formed by imported products. Considering all goods and services of health-related activities, the participation of imported goods in the overall supply fell, having changed from 4.9%, in 2005, to 4.5%, in 2007 (Table 14). Considering only goods (ranging from pharmaceutical/chemical items to healthcare gases), the percentage of imported goods in the total offer changed from 14.3% to 13.8%.

The highest average annual income⁵ of Health-related activities was obtained by workers of Hospital activities  (R$ 43,700). The sector of Manufacturing of pharmaceutical products paid, in 2007, the second highest compensation by position in Health-related activities (R$ 41,158), followed by Manufacturing of healthcare gases (R$ 37,905). The lowest annual income was that received by workers of  Private social services (R$ 5,570).

In 2007, the average income of Hospital activities, for example, was about 3.7 times higher than the average of economy in the period. The income of this activity increased more than that of the average of economy between 2005 and 2006, however, a little less than in 2007.

Non-hospital services and medicines concentrate most of household expenditure on health

Household expenditure on health-related goods and services, between 2005 and 2007, accounted, on average, for 4.8% of GDP, and reached R$ 128.8 billion, in 2007. The main items in the final household expenditure were Other healthcare services¹ (1.7% of GDP) and Medicines for human use (1.7%) - R$ 46.1 billion and R$ 44.8 billion. Household expenditure on hospital services reached R$ 22.3 billion.

Government expenditure on health-related activities rose from 3.3% to 3.5% of GDP, between 2005 and 2007, whereas the expenditure of non-profit institutions at family service remained stable at 0.1% of GDP, in the period. Public Health Services represented the main item in the final consumption expenditure of general government (2.9% of GDP), in 2007, amounting to R$ 76.5 billion. General government also has expenditure of 0.4% of GDP on private hospital services (for hospitals which have partnership with SUS) and of 0.1% of GDP on Other healthcare services (also for associate private establishments). Medicines distributed among families by the government – and not administered inside health establishments – are registered as final consumption expenditure of the general government with Medicines for human use² The amount spent on them represented 0.2% of GDP.

The consumption of goods and services by households increased both in 2006 (3.8%) and in 2007 (4.6%), but was overcome by the rise of other goods and services (5.4%, in 2006, and 6.4%, in 2007). In both years, the volume change of final consumption of goods and services by general government increased 7.4% and 5.8%, respectively, whereas the consumption of non-health-related products also increased, by 1.6% and 5.0%. The real change of consumption of goods and services by the public sector surpassed that of consumption by households in both years analyzed. The volume change of consumption of goods and services of non-health related services was higher than that of the general government in the two years.

General Government distributed R$ 4.7 billion in medicines in 2007

The distribution of general government expenditure on final consumption of goods and services did not change significantly in the period. At current values, expenditure increased 32.6%, between 2005 and 2007. Of the total expenditure in 2007, 63.1% corresponded to health services referred to general government and 13.0% market health-related services acquired by the general government and freely distributed among families. Expenditure on health-related services reached 76.2% of the total. Expenditure on medicines³ for free distribution represented 5.1% of the total public administration, corresponding to R$ 4.7 billion, in 2007.

By dividing exports by the overall demand, for each product, it is possible to see the participation of exports in demand. In 2007, for example, 10.0% of Material for medical/hospital/ dental care use available on the market was exported (Table 15).

Concerning the type of participation in the job market⁶, among the 4.2 million positions in the Health sector, in 2007, 2.9 million had a formal employment contract; 637.7 thousand referred to own-account workers and 618.2 thousand were positions without a formal contract. The activity of Public health services concentrated 1.2 million positions with a formal contract and 119.9 thousand positions without a formal contract.

 In 2007, the sector with the biggest number of positions without a formal contract in the sector of Health was Other healthcare activities, in which the sum of job posts of own-account workers (329.7 thousand) and of workers without a formal contract (261.0 thousand) reached 590.7 thousand, surpassing the number of positions with a formal employment contract (542.7 thousand).

With 2.9 million  formal job posts in 2007, the group of Health-related activities accounted for 7.2% of the total formal positions of economy. The activity with the highest level of formal hiring was Hospital services, with 248.6 thousand jobs with a formal contract and 1.9 thousand of own-account positions.

The three activities with the biggest increase in the number of formal jobs were Public health services (197.5 thousand new positions between 2005 and 2007),  Trade of pharmaceutical, medical, orthopedic and dental care products  (101.5 thousand) and Other health-related activities (62.0 thousand). The number of formal jobs in Hospital services increased by 20 thousand in this period.

The activity with the biggest number of own-account positions and workers without a formal contract was  Other healthcare services. The number of positions of Public health services without a formal contract may be associated to the hiring, in the period, of workers cooperatives. Job posts, in the period, may be classified as occupation without a formal contract. These jobs are not necessarily directed to doctors, but to any positions in Public health establishments.

Public health services have biggest number of occupations

Between 2005 and 2007, the participation of job posts in health-related activities considering total job posts in the country increased from 4.3% to 4.4 %⁴. In absolute figures, about 335 thousand new job posts were created by health-related activities in the period.

The sectors with the biggest number of positions are the ones with the highest value added: Public health services (1.4 million positions) and Other health-related activities (1.1 million positions). The third activity with the biggest number of occupations is Trade of pharmaceutical, medical, orthopedic and dental care products  (786.4 thousand positions).

Activities with the biggest increase in the number of positions, in the period 2005-2007, were Trade of pharmaceutical, medical, orthopedic and dental care products, with 105.3 thousand new positions mil; Other health-related activities, with 97.0 thousand and Public health services, with 96.4 thousand.

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¹ Other healthcare services include appointments and exams, mainly those in ambulatory care.

² Final government consumption expenditure on medicines refer to medicines distributed among the population. These do not include medicines used in public health establishments - which are intermediate consumption of the activity of Public health services, as well as transfers to the program called Popular Pharmacy .These figures are not also related to the production of medicines by official laboratories. In 2007,the production of medicines by official laboratories was R$ 1.1 billion, out of which R$ 184 million had been registered in health accounts as the output of pharmaceutical industry  (since they had been produced by laboratories covered by IBGE's Annual Survey of Industry).

³ The overall expenditure on medicines did not include transfers to the Popular Pharmacy program. 

⁴ Not including positions in the public health sector of defense and security.

⁵ Average income refers to all workers emloyed in the activity and not to average specific professional categories. In case of hospital services, the calculation of income includes, besides compensation received by health professionals, administrative workers and professionals performing support activities who are directly paid by hospitals.

 ⁶ Positions may be of continued or not-continued employment. Among those without a formal contract are included own-account activities and activities performed without an employment contract.