Tuesday

22nd Jan 2019

Opinion

Europe needs incentives to combat chronic disease

  • Chronic diseases are exacerbated by behaviour - smoking, alcohol consumption, lack of physical activity, and poor diet (Photo: Steve Baker)

This was a tumultuous year for the European Union, marked by continued economic malaise and the United Kingdom's historic decision to launch the process to leave.

Some are questioning whether the EU can survive the loss of its second-largest economy. Looking ahead to 2018, the inevitable belt-tightening will put public health budgets on the chopping block even as Europe faces a growing double-burden of aging and chronic disease.

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As our leaders aim to get the EU back on track, they should remember that healthy populations are the basis for strong economic growth. Short-sighted policies that neglect public health and stifle future medical innovation will only deepen current problems.

The European Commission sounded fresh alarm on chronic diseases in The State of Health in the EU, published in conjunction with the OECD, the Paris-based club of wealthy nations, in October.

This biannual survey of European countries found that chronic diseases – cancer, diabetes, hypertension and others – comprise up to 80 percent of EU healthcare costs on average. The related deaths among working-age adults cost the continent €115 billion in lost productivity each year.

Because chronic diseases are exacerbated by behaviour - smoking, alcohol consumption, lack of physical activity, and poor diet - an ounce of prevention is truly worth a pound of cure.

More aggressive investment in deterring these behaviors would reduce treatment costs and boost economic productivity to the tune of billions of euros each year.

Yet, while politicians pay lip service to these grave concerns, EU member states spend on average only three percent of health budgets on prevention. Some measures have been adopted, such as the banning of online advertisements for alcohol.

Missing, however, are reasonable education programs to promote physical health and nutrition. Such measures require both political will and funding to properly implement them - both of which are in short supply in the current environment.

Equally important is avoiding short-sighted policies that seek quick fixes where none are needed. Chief among these is a persistent attack on protections and incentives for the discovery of new medicines.

The European Commission is only the latest institution to approach health care from this perspective. Based on the council conclusions of June 2016, the commission has been preparing an economic analysis of the impact of incentives on access to medicines, with the aim of proposing legislation in 2018.

The logic goes that by weakening incentives extended to biopharmaceutical companies for the discovery of new medicines to treat, for example, pediatric and rare diseases, governments might save a few dollars or somehow increase access to these medicines.

My many years as a practicing doctor and public official - including a term as Austria's health minister - have shown me that this is a sorely misguided effort.

Specific incentives for the research and development of pediatric treatments have spurred the discovery of 1,800 new medicines, providing families with more options in caring for children with debilitating conditions like juvenile arthritis.

Furthermore, establishing incentives for rare disease treatments in 2000 has led to a 16-fold increased in new medicines approved by the European Medicines Agency.

Diminishing these incentives won't put more treatments into the hands of people who need them most. But it will make it harder to produce these numbers going forward. With more than 7,000 new treatments in development - including hundreds targeting chronic diseases - this a big risk to take.

The EC review threatens to undermine such incentives at a time when we need more medical innovation - not less - to turn the tide against chronic diseases.

While I've personally felt the frustration of struggling to contain rising health care costs, the role of these incentives is part of a century of medical innovation that has yielded unprecedented gains in quality of life.

Look at what has been accomplished in just the past few decades.

European life expectancy has risen by six years since the 1990s. HIV has become a treatable illness. Hepatitis C is curable in 90 percent of cases. And more half of patients diagnosed with cancer live another five years.

These advances are unambiguously the product of incentives for medical innovation.

Any effort to undermine them will only deter inventors and investors at a time when the science of innovation is becoming riskier and more expensive.

While the specter of chronic diseases is daunting, there is a clear path to victory. European member states must invest more in prevention and avoid policies that deter vital investments in future treatments and cures.

I hope that when Austria assumes the oresidency of European Commission in July, it will keep a clear focus on public health and embrace these positions with vigor.

The future of the European Union may well depend on it.

Andrea Kdolsky was Austria's minister of health and family affairs from 2007 to 2008.

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