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Expectations about Seismic Shifts in Global Healthcare Spending and Payment Reforms
Key themes from expert webinar about the IQVIA Institute report on Global Medicine Spending and Usage Trends: Outlook to 2025 Held Tuesday, May 18, 2021
Murray Aitken, Executive Director, IQVIA Institute for Human Data Science
Jun 24, 2021
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One of the important fallouts from the global COVID-19 pandemic may be seismic shifts in global healthcare spending, which may include an increase or reallocation in spending on health in middle- and low-income countries and accelerated efforts to advance new models for financing and payment reforms in healthcare.

This was one of the key themes that emerged from a webinar we at the IQVIA Institute for Human Data Science convened on Tuesday, May 18, 2021, to discuss the findings of our new report, Global Spending and Usage Trends: Outlook to 2025. Watch the webinar on-demand.

The webinar, which I moderated, brought perspectives from the following experts:

  • Thomas Bollyky, Director of the Global Health Program at the Council on Foreign Relations
  • Thomas Cueni, Director General of the International Federation of Pharmaceutical Manufacturers and Associations
  • Amanda Glassmann, Executive Vice President at the Center for Global Development
  • Panos Kanavos, Deputy Director, LSE Health, London School of Economics

Here are some excerpts from the conversation during the webinar:

Increase in total budgets or a shift in spending on health

There was consensus among the panelists that the COVID-19 pandemic may lead to pressures for increased spending, in particular in middle- and low-income countries that have been hit very hard by the pandemic, forcing more people to live in poverty. This trend will be fueled by a growing recognition that health spending is tightly linked to economic growth, and that there are negative consequences on population health outcomes stemming from increases in unemployment.

Furthermore, the concerns about other potential cases of zoonotic diseases spreading from animals to humans and leading to other corona-virus-type pandemics will incentivize governments to spend more on healthcare as part of future pandemic preparedness.

However, there were different opinions on whether the increase in spending related to COVID-19 vaccines and therapeutics will lead to an overall growth in total healthcare budgets, or if it will crowd out other areas of potential spending on healthcare, including non-communicable diseases such as cancers.

Some panelists also expect more involvement by finance ministers moving forward in areas such as drug pricing and the procurement process around healthcare spending.

Payment reforms will accelerate

One of the implications of the pressures on increased spending on healthcare will be efforts to advance new approaches to financing, including targeted funding and payment reforms.

The fact that 5-10% of the population consumes about two-thirds of the entire spending on healthcare services and medicines suggests those healthcare systems will be focused on better targeting of their healthcare spending, rather than necessarily increasing the total healthcare bill.

Payment reforms and new models for procurement may be unavoidable, with the rise in the number of novel, innovative therapies for chronic diseases in addition to the pressures from growing demand for vaccines and therapeutics to prevent and treat infectious diseases.

Yet middle- and low-income countries are likely to struggle with payment reform, as most of these countries don’t have DRG-systems like high-income countries, and therefore will tend to continue with input-based payment models rather than output- and value-based approaches.

Restructuring of the global vaccine industry

The global innovative pharmaceutical industry has responded effectively to the pandemic, delivering vaccines to fight COVID-19 with unprecedented speed. The global pharmaceutical supply chains also held up surprisingly well despite the disruptions.

Hopes were expressed that the COVID-19 innovations in vaccines could lead to innovations on the therapeutic side, which so far have been disappointing.

The panelists predict a fundamental transformation of the global vaccines industry, which may lead to industry consolidations and a positive spillover to disease areas other than COVID-19, such as HIV. This trend may be accelerated by growing political demands for universal vaccination programs for a broader range of infectious diseases, including influenza.

However, caution was articulated that the massive efforts to pursue innovations in mRNA-technologies, both in infectious diseases and in oncology, may not turn out to be the desired game-changer.

The challenges for the European Union

The panelists addressed the challenges that the European Union has faced responding effectively to the COVID-19 pandemic when it comes to the development of vaccines and implementation of immunization programs.

The EU is not expected to implement successful approaches such as the U.S. Warp Speed program, and member states are not likely to delegate more authority to Bruxelles, despite some attempts by countries to collaborate on vaccines, as seen in the Benelux.

Download our full Global Medicines report.

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