Healthcare improving too slowly to meet rising strain of chronic diseases


4/11/2015 - Too many lives are still lost in OECD countries because healthcare quality is improving too slowly to cope with ageing populations and the growing number of people with one or more chronic diseases, according to a new OECD report.


Health at a Glance 2015 shows that overall health expenditure continues to grow slowly in many OECD countries in line with GDP growth, although health spending fell in 2013 for a third consecutive year in Italy and Portugal and a fourth in Greece.


The new edition of Health at a Glance provides a set of dashboards allowing readers to visualise the relative performance of different OECD countries on selected indicators. These dashboards show that all countries have wide scope for improving the quality of health care and tackling unhealthy lifestyles, such as obesity and harmful alcohol consumption.


No country consistently performs at the top of the country ranking on key indicators of quality of care, even those that spend the most on health. There is room for improvement in all countries in the prevention, early diagnosis and treatment of different health problems.


The United States, for example, is doing well in providing acute care for people having a heart attack or a stroke and preventing them from dying, but is not performing well in preventing avoidable hospital admissions for people with chronic conditions such as asthma and diabetes. The reverse is true in Portugal, Spain and Switzerland, which have relatively low rates of hospital admissions for certain chronic conditions, but relatively high rates of mortality for patients admitted to hospital for a heart attack or stroke.


Finland and Sweden do relatively well in saving the lives of people following diagnosis for cervical, breast or colorectal cancer, but the survival rates for these types of cancer is lower in Chile, Poland, the Czech Republic, the United Kingdom and Ireland.


Pharmaceutical spending


Health at a Glance 2015 shows that pharmaceutical spending reached around USD 800 billion across OECD countries in 2013. This amounts to about 20% of total health spending on average.


The growth of retail pharmaceutical spending has slowed in recent years in most OECD countries, while spending on pharmaceuticals in hospital has increased in some. Many countries have implemented policies to boost the generic market, which has contributed to the slowdown or reduction in pharmaceutical spending, but the share of the generic market still remains relatively low in countries such as Switzerland, Italy, Greece and Japan.


Despite the recent slowdown in spending growth, ageing populations and the high cost of new specialty drugs for diseases like cancer and hepatitis will likely cause spending to rise again, says the OECD.


New specialty drugs are expected to account for 50% or more of pharmaceutical spending growth within the next five years. While some of these high-price medicines bring great benefits to patients, others provide only marginal improvement in the health of patients and are not cost-effective.


The consumption of antidepressants has grown quickly since 2000, nearly doubling on average across OECD countries. There is evidence in several countries where consumption is high, such as Australia and the United Kingdom, that there is some over-prescription. At the same time, however, consumption may need to increase in others, such as Korea and Estonia, in order to address unmet needs for people suffering from depression.   


Expenditure on pharmaceuticals per capita, 2013 (or nearest year)



1. Includes medical non-durables (resulting in an over-estimation of around 5-10%)
2. Excludes spending on over-the-counter medicines
>> Download the data in Excel



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Working with over 100 countries, the OECD is a global policy forum that promotes policies to improve the economic and social well-being of people around the world.



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