Investing in Health – Commission Staff Working Document

2013 03 21 Written by Vaccines Europe

Investing in Health’ is the recently published EU vision on how to optimise health policies effectiveness and efficiency in the Member States. It comes as a complement to the European Commission Social Investment Package on how structural reforms in social policies can contribute to smart and sustainable growth. The document proposes to outline how investing in health contributes to the Europe2020 objectives.

According to the report, mounting evidence suggests the potential of improving resource allocation and cost-efficiency in the delivery of healthcare goods and services without increasing health spending per se. Better spending at national level is determined not only by how much money is spent, but also how it is spent – which ultimately impacts health status and quality of healthcare provision.

The European Commission and the Economic Policy Committee have therefore identified key priority areas for intervention where structural reforms could accrue savings and contribute to healthcare systems sustainability, including the following:

  • Cost-effective provision and use of health services through adequate incentives
  • Reducing the unnecessary use of specialist and hospital care
  • Better health promotion and disease prevention in and outside the health sector
  • Ensure a balanced mix in staff skills
  • Improve data collection
  • Use HTA more systematically for decision-making processes

While there is broad evidence and support that preventing the onset of diseases can yield cost-saving long-term returns on investment, spending on prevention in EU Member States mounts to 3% of current public health expenditure only.

Prevention covers a wide-array of policies and programmes to enhance quality of life and reduce high treatment costs, from awareness-raising and literacy activities to life-style related measures to reduce the incidence of chronic diseases. The Commission report points to a number of additional measures that authorities could make use of in different settings to enhance health promotion, such as at school, work or in health institutions.

Vaccines Europe strongly supports the need for better health promotion and disease prevention, and believes that the full implementation of national immunisation programmes is crucial to the achievement of the ‘Investing in Health’ vision. This makes the case for (a) the need for increased appropriations to public health prevention programmes as a proportion of overall healthcare spending and (b) evidence-based prioritisation in prevention spending.

Infectious diseases are a major cause of morbidity and mortality in the EU; more so with an increasingly elderly population which is more likely to suffer from multiple diseases. Immunisation plays a major role in reducing incidence and impact of numerous vaccine-preventable diseases in these fragile population segments and throughout other stages of life, including adolescence and adulthood. Immunisation keeps individuals healthy, reduces the consequence of illness, and alleviates the burden of disease in individuals affected by specific conditions, such as chronic diseases.

Nevertheless, despite the availability of cost-effective vaccines, their uptake for the prevention of burdensome and costly illnesses in public health, economic, and social terms is often low.

This is due to multiple often hard-to-address factors ranging from vaccinees’ hesitancy and lack of awareness of disease risks to barriers in access and poor information to and training of healthcare professionals. The latter should be a key target of government strategies to ensure the delivery of successful immunisation programmes. Innovative technologies and breakthrough eHealth tools could help overcoming several of these barriers.

Better recognition of the role of immunisation as part of EU Member States prevention strategies should form integral part of efforts to achieve more value for money. In line with the Conclusion of the Commission report, this would enable “smarter spending” rather than “more spending” while contributing to better population health outcomes and economic productivity gains.