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Healthcare

Sustainability

In light of the EU’s need for more accessible and innovative healthcare systems, questions on sustainability receive increasing attention. The combination of an ageing population and the expansion of chronic diseases drives public expenditure in health promotion upwards, creating pressures on the resources. Therefore, decision-makers often have to face the twin objectives of containing costs and ensuring high accessibility and quality of services.

EFA advocates for the sustainability of health systems through policy solutions at the European level that promote greater collaboration and participation among Member States, as well as stakeholders. In this respect, we believe that the Cross-Border Healthcare Directive includes principles that benefit both causes: patients’ access and Member States’ budgets.

Two of the most prevalent sustainability aspects of healthcare systems are the costs related to the hospitalisation and the reimbursement of healthcare services. 

Hospitalisation

Hospitalisations are rising in the EU – so are the costs linked with it. Not unexpectedly, this has also a negative impact on the quality of care, as countries with more hospitalisations per capita tend to  also have higher shares of preventable ones, an EU study has shown. In line with wider tendencies, all EFA disease areas have seen their numbers of hospitalisations increase sharply, with the case of asthma and allergy among children being particularly alarming.

Reimbursements

National Authorities in Europe are responsible for setting prices of medicines and deciding the treatments that will be reimbursed under their social security system. The pharmaceutical pricing and reimbursement systems established by Member States are usually quite complex. Each country uses different schemes and policies, adapting to its own economic and health needs. These national systems are under constant adaptation in order to take account of political priorities, market evolution and patient needs.

The European Union has a major role to play in this area. Pricing and reimbursement systems are closely linked to the realisation of European policy objectives, such as the internal market, pharmaceutical competitiveness, sustainable research and development or human health protection. To ensure that national pricing and reimbursement decisions do not interfere in the functioning of the internal market, the EU has adopted the “Transparency Directive”. 

The European Commission initiatives in the field of pricing and reimbursement therefore seeks to foster cooperation through the establishment of a structured dialogue between the competent national authorities and all relevant stakeholders. The core objective is not only to enhance the functioning of the internal market, but to also ensure that national systems achieve an adequate balance between cost-containment, pharmaceutical innovation and patient access to medicines.

Reimbursement policies have the potential to widen health inequalities between citizens and at EFA we strongly advocate for:

  • A common European approach on reimbursement for chronic diseases;
  • The systematic reimbursement of preventative care for asthma, allergy and COPD;
  • The adoption of reimbursement rules that ensure patients' access to medicine and good treatment.

Access to healthcare is one of our key work and we are currently focused in the following policy priorities:

  • Adopt an EU strategy on chronic diseases with disease specific chapters;
  • Strengthen patients’ safety, improve accuracy and quality of information to patients, boost health literacy and patients’ participation in decision-making;
  • Ensure early and accurate diagnosis of allergies and chronic respiratory diseases through increased training for healthcare professionals, development of national programmes, registers and spirometry testing;
  • Eliminate discrimination of patients based on their disease or condition;
  • Ensure that more funds are allocated for EU health policy, programmes and prioritise investments in research of allergic and respiratory diseases.

Our advocacy activities on healthcare are voiced and supported by the European Patients’ Forum (EPF), an EU umbrella organisation of which we are full members.

EFA’s documents and activities in access to care