The direct costs caused by illnesses and health problems in Germany amounted to €528.5 billion in 2024. According to the Federal Statistical Office (Destatis), this represents a 7.6 percent increase compared to the previous year, or an increase of €37.5 billion.
In the same period, the average per capita healthcare cost rose by €430, reaching €6,330. There is a notable gender gap: the per capita costs for women were €1,280 higher than those for men, standing at €6,960 compared to €5,680. Direct healthcare costs include expenses associated with medical treatment, prevention, rehabilitation, and care, but they do not cover the full economic burden of illness, such as lost wages, according to the statistics office.
In terms of the greatest causes, diseases of the circulatory system and mental and behavioral disorders ranked highest in 2024. Circulatory system diseases accounted for 13.1 percent (€69.4 billion), closely followed by mental and behavioral disorders at 13.0 percent (€68.7 billion). Together, these two categories made up over a quarter (26.1 percent) of all healthcare costs. Musculoskeletal disorders followed, contributing 10.3 percent (€54.3 billion), with digestive system illnesses accounting for another 10.2 percent (€53.7 billion). Neoplasms (cancers) made up 9.9 percent (€52.1 billion). Over the longer term, these five major disease categories have accounted for between 55 and 56 percent of the total costs since 2015.
A key factor driving the higher per capita costs for women is the demographic structure, including gender-specific illnesses and costs related to pregnancy and birth, though the increased life expectancy and the higher proportion of elderly and very elderly women contribute significantly. In the 85-and-older age cohort of roughly 2.9 million people in Germany in 2024, nearly two-thirds (65.0 percent) were female.
Comparing the costs by gender reveals specific differences in illness types. For women, mental and behavioral disorders-which include dementia-resulted in the highest per capita costs at €990, making them 1.5 times higher than the corresponding cost for men (€650). Women’s second and third most expensive categories were musculoskeletal diseases (€840) and circulatory system diseases (€800). Conversely, cardiovascular diseases led the cost structure for men at €860, followed by mental and behavioral disorders (€650) and neoplasms (€630). For both genders, digestive system diseases held the fourth position (€660 for women and €630 for men). The fifth most expensive category for women was neoplasms at €610, while men’s fifth category was musculoskeletal diseases (€450).
Costs increase significantly with age. In fact, the population aged 65 and older generated over half of the total costs (53.8 percent, or €284.3 billion). For this age group, the per capita cost reached €15,080. The lowest costs were observed in the 15-to-29 age bracket at €2,390, followed by those under 15 at €2,620. The costs for those aged 30 to under 45 were €3,130 per person, lower than the cost seen in the 45-to-under-65 group (€5,590). The costs rose sharply in the 65-to-under-85 group (€12,300), reaching a peak of €30,150 per person for the very elderly (over 85).
