Non-communicable diseases are placing an increasing strain on EU health systems, driving up costs and shortening life expectancy. A new report highlights that investing in prevention and treatment saves lives and yields significant economic benefits.

The report, written by R-Health Consult, and commissioned by the European Federation of Pharmaceutical Industries and Associations (EFPIA), outlines key findings on the economic and health benefits of investing in prevention, early detection, and treatment for five major non-communicable diseases (NCDs) – stroke, ischemic heart disease, type 2 diabetes, chronic obstructive pulmonary disease, and breast cancer – across all 27 EU member states.

It highlights the return on investment with specific insights from Sweden, Romania, and Portugal. For every €1 invested, productivity gains amount to €1.4 in Portugal for diabetes, €1.1 in Romania for cardiovascular diseases, and €4.9 in Sweden for breast cancer.

“Rather than an expense, healthcare should be recognised as a strategic investment in human capital, yielding significant returns in terms of both economic growth and improved quality of life for all citizens,” said the report authors.

They add that “This paradigm shift is particularly critical given the rising burden of NCDs and the demographic trend towards an ageing population, both of which necessitate sustained, long-term investment in health systems.”

NCDs burden

In 2023 alone, the five selected NCDs accounted for 1.5 million deaths across the EU. Without intervention, the annual death toll is expected to rise to 2.2 million by 2050, marking a 50% increase.

The economic impact was also substantial, with these diseases costing the EU approximately €530 billion, or 3.13% of its combined annual GDP. The most significant contributors were direct healthcare costs, amounting to 60.5%.

Beyond direct healthcare costs, the burden extends to economic losses from missed workdays, reduced productivity, and premature mortality.

Sweden has untapped potential

Cancer incidence in Sweden increased by over 30% between 2012 and 2022, and breast cancer rates are projected to go up by 20% by 2050 and mortality by 30% by 2050.

The country has successfully reduced hospital admissions for chronic diseases and is among the EU’s top performers in oncology, including breast cancer.

Even with a strong track record, Sweden can do more to improve interventions.

Dag Larsson, Senior Advisor at the Swedish Association of the Pharmaceutical Industry (LIF) and co-contributor of the report, told Euractiv: “We know that breast cancer care in Sweden results in good outcomes and that the survival rates are increasing, and morbidity is decreasing.”

However, he added: “But even in a successful country like Sweden, more can be done. You could always do better. And the better the quality of the interventions is, the better the effect you get.”

When discussing the specifics, Larsson highlighted room for improvement in waiting times for treatment.

“In Sweden, different cancer diagnoses have different planned times from well-founded suspicion to the start of treatment, but sometimes patients have to wait longer than that, and it is important to shorten that time, as well as to focus on improved diagnosis, treatment and follow-up,” he added.

What do you prioritise?

Douglas Lundin, chief economist at the Swedish Dental and Pharmaceutical Benefits Agency (TVL), told Euractiv that he sees risks with the report’s key message perspective in some cost-benefit analysis aspects.

While health budgets are finite, health interventions, such as medicine reimbursement, are limited and require triage.

The TLV determines which prescription medicines qualify for government reimbursement and advises the regions responsible for healthcare in Sweden.

Lundin underlined that the TLV already prioritises the health outcomes in its cost-benefit analyses. However, he perceives that the proposed perspective could be unjust for certain groups of patients.

“The TLV used to weigh in gains, such as if a drug could help someone go back to work when deciding whether or not to reimburse a drug. But then we saw that this perspective was really unfair in terms of decisions for patients who were not working, such as children or retired people,” he continued.

“So, the TLV is now very hesitant to consider such effects when deciding which drugs to reimburse,” Lundin added.

However, he concluded that his personal belief is that it may be meaningful to consider the effects on the ability to work when evaluating public health measures directed to large parts of the country’s population.

Romania’s heavy NCD burden

In 2023, the cumulative burden of the five main NCDs in Romania resulted in 275,071 new cases and 116,762 deaths, representing 1.3 million years of life lost.

 Cardiovascular diseases alone accounted for over 55% of all deaths in 2020, with ischemic heart disease and stroke as major contributors.

Romania’s ageing population further intensifies these challenges. Older individuals are more likely to suffer from multiple chronic conditions, increasing demand for healthcare services and driving up costs.

By 2050, the number of new stroke cases is expected to rise by 28% annually, while ischemic heart disease cases are projected to increase by 26%.

Deaths from these conditions are also set to climb, with stroke-related fatalities rising by 49% and those from ischemic heart disease by 39%.

The report underscores that as NCDs become more prevalent, the economic burden will grow, increasing strain on the healthcare system to deliver effective and equitable care.

A national strategy

Euractiv spoke with Dr Ioana Bianchi, External Affairs Director of the Romanian Association of International Medicine Manufacturers (ARPIM) and co-contributor of the report, about the need for better chronic disease management and stronger preventive measures to address the impact of NCDs in Romania.

Dr Bianchi highlighted the Romanian government’s recently approved National Strategy for the Prevention of Cardiovascular and Cerebrovascular Diseases 2024-2030 as a key step in tackling the country’s NCD burden.

The Strategy outlines targeted interventions to address the country’s high cardiovascular disease burden, aligning with EU recommendations and covering all aspects of care.

Prevention measures include reducing smoking, optimising diet, promoting physical activity, controlling psycho-social factors, fighting obesity, arterial hypertension, diabetes, dyslipidemia, and chronic renal disease.

Treatment and secondary prevention efforts focus on enhancing diagnostic and treatment protocols, ensuring faster access to medications, expanding specialised cardiac centres and units, improving funding, and developing registries for cardiovascular diseases that can benefit from interventional cardiology and cardiac surgery.

The goals for cardiac rehabilitation are to primarily take place on an outpatient basis, with a target of at least 90%. Rehabilitation programmes should include at least 80% of eligible patients with acute coronary syndromes, at least 40% of those with chronic coronary symptoms, and at least 30% of eligible patients with heart failure.

“The Strategy will be financed from the state budget, in the framework of the existing legislation or by creating new legislative acts and improving budget allocations,” Dr Bianchi explained.

Portuguese struggles with diabetes

In Portugal, the high prevalence of NCDs – including one of the world’s highest diabetes rates at 9.1% – is a major driver of rising healthcare costs. In 2023, the five main NCDs accounted for 143,509 new cases and 34,757 deaths, resulting in over 393,090 years of life lost.

If incidence and mortality rates remain unchanged, annual new cases are projected to rise by 10% by 2050, while deaths could increase by 50%.

Although Portugal’s life expectancy surpasses the EU average, this longevity brings challenges. Nearly 61% of people over 65 live with health-related limitations, with women particularly affected – spending only a third of their later years free from disability.