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Turning Good Intentions Into Action: How to Tackle the World’s Number One Killer

NCDs or non-communicable musculoskeletal disease, are diseases of long duration, generally slow progression, and are typically non-infectious. NCDs often bear a heavy burden of associated additional disorders or diseases (‘comorbidities’). They include diabetes, musculoskeletal diseases, many cancers, chronic respiratory disease, cardiovascular disease, and neuropsychiatric conditions like dementia.  

The world’s number one killer

The scale of the NCD challenge is staggering. They account for two out of three deaths globally, and in Europe, NCDs kill more people each year than all other causes combined, responsible for 86% of all deaths, and accounting for an estimated 70-80% of healthcare expenditure. [1]

As a result, NCDs are having a suffocating effect on the economy.  In the case of musculoskeletal diseases for example, although they have a low impact on mortality, they account for a higher proportion of sickness absence from work than any other health condition, costing an estimated €240b annually in Europe alone.[2]  In addition, according to ‘The Global Economic Burden of Non-Communicable Diseases’, a report by the World Economic Forum and Harvard School of Public Health, half of those who die of chronic NCDs are in the prime of their productive years, so the disability imposed and the lives lost early are impacting significantly on economic prosperity and business competitiveness.

Looking to the future this trend is only expected to rise[3], and the economic burden is set to increase as rising chronic disease levels place extra demand on the economy through loss of productivity. Over the next 20 years it is anticipated that NCDs will cost more than US $30 trillion.[4]

In the face of such a stark reality, it is no surprise that finding ways to reduce morbidity and mortality rates from NCDs is high on the agenda of policymakers and healthcare practitioners alike. This year's World Health Assembly of the World Health Organisation set a target of reducing premature deaths from NCDs by 25% by 2025. But, as Alan Davies, GE Healthcare’s Medical Director, told The Economist’s live Summit – ‘New Responses to Non-Communicable Diseases’ in October 2012, “good intentions now need to be translated into tangible action and we need to address the ‘elephant in the room’ – who pays for it.”

The biggest elephant in the room is how to pay

While there is growing recognition of the scale of the problem, one of the biggest barriers to tackling NCDs in Europe is allocating adequate funds for innovative technologies and solutions that enable prevention and early and accurate diagnosis, and delivery of more efficacious and cost effective interventions and therapies.

From cutting edge imaging technology, to healthcare IT systems and new tools for capacity planning in hospitals, technology has the power to transform every stage of an NCD patient journey and improve the quality, productivity, effectiveness and efficiency of their healthcare delivery.

It is tempting, Alan explained, to see funding healthcare as a budgeting issue for governmental healthcare departments alone, but this is only one part of the equation. 

Health is really much more than the screening, diagnosis, therapy and monitoring of disease you’d traditionally consider as part of healthcare.  NCDs impact on so many areas of society, keeping people out of work, and stifling the economy, so there is every reason for policymakers to take a more holistic approach to funding.”

A recent study, for example, estimated that the economic burden of cancers alone in the EU amounts to €124 billion per year. This figure includes the direct health costs for cancer such as primary care, hospital care and medications, but also the cost of informal care and losses in productivity.[5]

“Ultimately policymakers and budget decision makers need to factor in the socioeconomic cost of doing nothing and weigh that against the decision to invest more in the solutions and technologies that will allow earlier intervention. Budget holders in areas outside of healthcare, like education, employment, and welfare, need to recognise the benefit to them of these medical technologies being implemented.”

Wherever the funding for crucial new technologies comes from, there is a need to keep them affordable, using smarter and more flexible financial solutions. These could include more extensive use of funding vehicles like Public Private Partnerships, or long term technology partnerships that offer economic and clinical benefit to hospital authorities, clinical staff, and patients.

[1]Economist Conferences

[2]National Rheumatoid Arthritis Society

[3]The Future of Healthcare in Europe – The Economist Intelligence Unit

[4]Source: The Global Economic Burden of Non-communicable Diseases – A report by the World Economic Forum and the Harvard School of Public Health

[5]ESMO 2012 Press Release: The true costs of cancer in Europe revealed