Health after COVID-19: spend more but spend smarter

As we enter the final stretch of 2020, we face a huge dilemma for public health and public finances: how do we manage the massive impact of COVID-19 and the increasing burden of chronic diseases without bankrupting public finances?
Nathalie Moll, Director General of the European Federation of Pharmaceutical Industries and Associations (EFPIA) | Source: EFPIA

By Nathalie Moll

Nathalie Moll is Director General of the European Federation of Pharmaceutical Industries and Associations (EFPIA)

13 Oct 2020

As we enter the final stretch of 2020, we face a huge dilemma for public health and public finances: how do we manage the massive impact of COVID-19 and the increasing burden of chronic diseases without bankrupting public finances?

There is a growing recognition of the urgent need to invest more in making our health systems more resilient, and that strategic investments in healthcare infrastructures can play an important part in Europe’s economic recovery.

It is essential that we use the resources we have as efficiently as possible and consider the long-term outcomes of health expenditure. Because we must absolutely avoid the cost-containment approach taken after the 2008 financial crisis, which had very detrimental effects on health and social wellbeing in Europe.

“It is essential that we use the resources we have as efficiently as possible and consider the long-term outcomes of health expenditure”

Luckily, looking at the long-term, we often find that improved health outcomes also mean lower overall costs for the system and society. Spending smart often means intervening at the right time, before a disease has led to serious complications for the patient and the system.

To take but one example, the screening programme for colorectal cancer in the Basque Country has led to a 26 percent reduction in the mortality rate. This reduces treatment costs and will bring net savings of €93m over time.

According to a study by the Office of Health Economics, if this success was to be replicated across Europe, all other things being equal, this would correspond to an additional 331,000 healthy life years gained per year and €9.9bn in savings.

Imagine if that money could be put to better use, maybe invested in digital health infrastructures or the latest cell- and gene therapies that are starting to transform the lives of millions of patients across Europe? EFPIA have published a white paper on strengthening health systems through smart spending, to give our view on how we could improve health systems’ resilience, responsiveness and readiness. Let me highlight two of the recommendations:

Measure health outcomes: Many health systems today measure efficiency based on outputs, not outcomes. 1,000 low quality cataract surgeries are not better than 500 high quality ones.

“EFPIA is ready and eager to discuss how we can improve the value of health spending in Europe together. It’s an issue we can’t afford to ignore”

Without better data on outcomes that matter to people and patients, we will never know what we actually get for our money.

Remove budget silos: Preventing or managing diseases often creates savings in other parts of the system. In order to incentivise smart spending, we need to create better links between different funding streams so that we can see the full picture and optimise spending.

EFPIA is ready and eager to discuss how we can improve the value of health spending in Europe together. It’s an issue we can’t afford to ignore.

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