According to calculations by the Ministry of Health, patient co-payment levels (calculated for reimbursable drugs only) could be reduced from 32% at present to 18%, if patients were always dispensed the cheapest generic dmg. With the 2011 Act on reimbursement of drugs, pharmacists no longer have any financial incentives to dispense the more expensive drugs, as the mark-ups are equal within the same substance group. Figure 16 shows how heterogeneous the size of PHI markets is across countries.