Key Takeaways
- The most expensive diseases in Germany are not always the rarest or most severe. Many rank highly because they affect millions of people and require ongoing care.
- Dental diseases generate the highest total expenditure at €32.8 billion or €390 per resident. Routine and repeated outpatient care (e.g., check-ups, fillings) adds up across millions of people.
- An ageing population plays a central role. Dementia, heart disease, and joint disorders become more common in older age groups and account for a growing share of health spending.
- Chronic conditions account for much of Germany’s healthcare spending. They require long-term management rather than one-time treatment, and costs accumulate gradually through medication, monitoring, and rehabilitation.
Top Diagnosis Groups by Healthcare Spending
| Rank | Diagnosis | Cost | |
|---|---|---|---|
| National Total (In Mill. €) | Per Resident (In €) | ||
| 1 | Diseases of the oral cavity, salivary glands, and jaws | 32,838 | 390 |
| 2 | Organic, including symptomatic, mental disorders | 24,701 | 300 |
| 3 | Other forms of heart disease | 21,846 | 260 |
| 4 | Cerebrovascular diseases | 16,539 | 200 |
| 5 | Osteoarthritis | 16,169 | 190 |
| 6 | Dorsopathies | 13,532 | 160 |
| 7 | Mood [affective] disorders | 12,024 | 140 |
| 8 | Diabetes mellitus | 9,685 | 120 |
| 9 | Chronic lower respiratory diseases | 8,678 | 100 |
| 10 | Ischaemic heart diseases | 8,414 | 100 |
Source: Destatis
ICD-10 is the World Health Organization’s coding system for diseases. Doctors and health systems use it worldwide to record diagnoses in a standard way. Diagnosis groups in this table reflect narrower disease blocks within that system, not its broad top-level chapters.
Costs are calculated with a top-down method. That means it starts from Germany’s total health spending and divides it across diagnosis groups, rather than adding up individual patient bills
Figures cover only direct health care costs and exclude indirect costs such as lost workdays. In practice, this counts money spent on treatment and care, not wages lost to sick days.
Per resident costs divide the national total by Germany’s population and do not represent the average treatment cost per patient. In practice, this is a per-capita figure spread across everyone in the country, not what a typical patient with that disease actually costs the system.
Germany’s biggest healthcare costs do not always come from the diseases that receive the most public attention.
In 2023, diseases of the oral cavity, salivary glands, and jaws accounted for the highest healthcare spending. Total costs reached €32.8 billion, or about €390 per resident.
This does not mean dental conditions are the most dangerous. It means they are the most common.
Almost everyone requires dental care at some point. Most treatment is provided on an outpatient basis. That means patients visit a clinic and go home the same day. Visits are also repeated over time. When care is routine and widespread, moderate expenses accumulate into a large national total.
The second largest block is organic mental disorders, which include dementia. This corresponds to about €300 per resident.
Here, the mechanism is different. Instead of high volume, the cost is shaped by duration:
- Long-lasting illness
- Ongoing supervision
- Long-term care needs
Dementia prevalence rises sharply with age, so it becomes more visible as Germany’s population ages. The financial weight reflects sustained care over years, not short hospital stays.
Germany’s Healthcare Expenditure Vs. Aging Population ->
Cardiovascular diseases appear repeatedly in the ranking, reinforcing how central they remain to the health system:
- Other forms of heart disease (€260 per resident)
- Cerebrovascular diseases such as stroke (€200)
- Ischaemic heart diseases (€100)
Together, they represent a substantial share of total health spending.
Cardiovascular disease remains a leading cause of death in Germany. Even when survival improves, long-term medication, monitoring, and rehabilitation continue. The result is not a single expensive episode but ongoing management. The cost accumulates quietly.
A similar pattern emerges with musculoskeletal conditions.
- Osteoarthritis: €190 per resident
- Dorsopathies (including chronic back problems): €160
These are rarely fatal illnesses. But they are widespread and persistent, especially in older age groups.
Treatment often involves physiotherapy, pain management, sometimes surgery, and long recovery periods. Again, it is the length of care that shapes expenditure, not dramatic intensity.
Mood disorders and diabetes mellitus reinforce this structure.
- Mood disorders: ~€140 per resident
- Diabetes: ~€120 per resident
Both require continuous management rather than one-time intervention. Regular medication, monitoring, and follow-up care extend across years.
Taken together, the per-resident figures clarify the broader structure of spending. The largest financial burdens are not primarily the result of rare emergencies or high-cost procedures. They stem from widespread and persistent conditions, especially in an ageing population.
In that sense, the health budget mirrors demographic reality. It is shaped less by sudden crises and more by the steady management of illnesses that endure over time.
More topics
- Leading Causes of Death in Germany
- Causes of Death in Germany By Gender
- Supplementary Health Insurance in Germany
- List of Private Health Insurance Companies in Germany
- Occupational Disability Insurance Germany
- Number of People in Private Health Insurance in Germany
- Number of Public Health Insurance Companies in Germany
- Increase in Public Health Insurance Premiums Between 1970 and 2026
- Trends in Public Health Insurance Membership
- Number of People Insured in Public & Private Health Insurance in Germany
- Private Health Insurance Benefits That Public Insurance Doesn’t Offer
- Public Health Insurance Additional Contribution
- Health Insurance After Retirement In Germany
- German Health Insurance Providers Increased Premiums for 2026
- Is Private Health Insurance Too Expensive In Old Age?
