Concurrently, cancer centers have decided to postpone monitoring consultations and operations considered to be non-urgent 11. In France, consultations have fallen by 40% among general practitioners and by 50% among specialists since the beginning of the epidemic, even when accounting for the surge of tele-consultations. For example, the inability or fear of high-risk patients to consult a doctor is disrupting chronic disease management and delaying some critical cancer care procedures. The second will be the growing “backlog” of healthcare procedures. The first will be the physical and mental exhaustion of the healthcare workforce, along with worn-out hospital infrastructure. In the near term, healthcare systems will face two major, additional, “collateral” issues. Leaders around the world are putting in place emergency measures to cope with this health crisis, adjusting in real-time and ‘spending each day fixing errors they made yesterday’. Immediate and near-term challenge: the Covid emergency and its collateral impact This raises a question on resource allocations while many immunization and some screening activities have shown to be cost-effective (and some even cost-saving), there is less consensus on the effectiveness of general (including dental) check-ups 10. In addition, nearly 50% of prevention spending was on healthy condition monitoring programs, such as check-ups and dental examinations, 25% on health promotion while both immunization and screening programs accounted for less than 10% each. Most of these countries spent between 2 and 4%, which has remained stable over the long-term. In 2015, less than 3% of healthcare spending went to prevention in OECD countries.In parallel, oncology is expected to have almost a 20% share of the worldwide market by 2024, and an 11.4% in CAGR growth 9. By 2024, orphan drugs are projected to make up one-fifth of worldwide prescription sales, amounting to US$242 billion 8.

In contrast, worldwide orphan drug sales are expected to have doubled at 12.3% over the 2019–24 period. Rare disease patients make up less than 0.06% of the population in the United States, less than 0.05% in the EU, and less than 0.04% in Japan 7.Incentivize innovation for smaller unmet needs and vulnerable populations primarily, increasing relative focus and spend on Specialty Care In the United States, aggregate hospital revenue from outpatient services grew from 30 percent in 1995 to 47 percent in 2016 5, while in England, from 2012 to 2016, the increase in inpatient admissions was 9% and outpatient attendances increased by 21% over the same period 6.In France, the number of overnight hospitalization beds decreased by 4.2% while outpatient care beds increased by 7.4% and in-home hospitalization increased by 3.4% from 2013 to 2018 4.

The number of people living, for example among chronic diseases, with diabetes is projected to increase by 48% to 629 million by 2045, with China (114.4 million), India (72.9 million), and the United States (30.2 million) topping the list 3.ĭrive efficiency, shifting care from hospital to outpatient settings.People aged over 65 will represent more than 11.8% of the total population by 2023, peaking at 29%in Japan and 22% in Western Europe 2.As Zhou Maigeng from the Chinese Center for Disease Control said last year, “going forward, the burden of chronic health problems, especially among the elderly, will far exceed infectious diseases” 1. Health issues related to lifestyle changes and an aging population made this type of healthcare burden more relevant for healthcare systems than pandemics.In many ways, the Covid pandemic is diametrically opposed to the direction that healthcare systems, particularly in developed countries, have been taking over the past years i.e., Focus resources on non-communicable, chronic diseases such as diabetes and cardiovascular conditions Debating these systems’ ability and efficiency to deal with it is therefore not relevant per se.

Across the globe, our healthcare systems were not designed to deal with this crisis: an unpredictable, large-scale health challenge that requires urgent mobilization of resources and affects the whole population.

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