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Cost of Non-Communicable Diseases in the EU

Table of Contents

1. Measuring the cost of non-communicable diseases
1.1 Healthcare costs
1.2 Non-healthcare costs

1. Measuring the cost of non-communicable diseases

Depending on the perspective adopted in an economic evaluation, e.g. public spending on health care or a wider societal perspective, the cost of disease can be estimated from costs associated with the delivery of healthcare and the non-healthcare costs, which also reflect productivity losses due to morbidity or mortality and also costs of informal care. The economic burden of non-communicable diseases (NCDs) is on the rise and is projected to show steeper increases in the future, especially in less developed economies and among the poor in middle- and high-income countries. Falling mortality rates across all ages are contributing to increasing life expectancy; however, decreasing mortality at the expense of increasing morbidity means more years spent with chronic illnesses (EC 2015). The key drivers associated with the high socioeconomic cost of NCDs are detailed below at 3 different levels (HNP 2011):

  • Costs at the level of individuals and households: increased disabilities and premature deaths, decreased household income, increased expenditures, including out of pocket payments for health, and loss in savings and assets, and reduced opportunities;
  • Health care delivery costs: more people living with NCDs leading to increased use of NCD-related healthcare services, high medical treatment costs and the demand for more expensive treatments;
  • Costs to national economies: including reduced labour supply, reduced labour outputs (e.g. absenteeism), lower tax revenues and lower returns on human capital investments.

Public health expenditure is among the largest and fastest growing spending items for governments. In 2015, public expenditure on health was 7.8% of GDP in the EU as a whole, with more than 70% of expenditure funded by the public sector in two thirds of Member States (EC 2017). In 2013, premature deaths due to major NCDs (cardiovascular diseases, cancers, respiratory diseases and diabetes) cost EU economies 0.8% of GDP (OECD/ EC 2016), with further losses incurred due to the lower productivity and employments rates of people living with chronic health problems. Due to population aging, chronic diseases and the diffusion of new diagnostic and therapeutic technologies, the share of GDP spending on health is projected to increase in the coming years (EC 2015, OECD/ EC 2016). In most high and middle-income countries, non-communicable diseases are responsible for the biggest share of such healthcare costs (EC 2014).

1.1 Healthcare costs

Cost-of-illness studies have estimated the cost to EU health care systems from cardiovascular disease (CVD) and cancer. The estimates include costs due to primary care, outpatient care, accident and emergency, inpatient care and medications/drugs. The healthcare costs for CVD and cancer have been estimated as follows:

  • CVD cost EU health care systems just under €111 billion in 2015, approximately €19 billion due to ischaemic heart disease (IHD) and €20 billion due to stroke (EHN 2017). Other CVDs such as hypertension and other forms of heart disease may account for a significant portion of total costs (Leal et al. 2006);
  • Cancer cost the EU €51 billion in 2009 (Luengo-Fernandez 2013);

The estimated country-based healthcare costs caused by CVD (ischaemic heart disease and stroke) and cancer are listed in Table 1.

Estimates of healthcare expenditure due to diabetes in the adult population (aged 20-79 years) have also been performed for the European Region (IDF 2017): In the International Diabetes Federation European Region (IDF Europe countries) it is estimated that in 2017 expenditure was 181 billion international dollars. 

1.2 Non-healthcare costs

Non-communicable diseases also result in non-healthcare costs, for example productivity losses due to morbidity or mortality and costs of informal care. Studies have estimated these costs as follows:

  • production losses due to mortality and morbidity associated with CVD cost the EU €54 billion in 2015 and the total cost of providing informal care for people with CVD was €45 billion (EHN 2017);
  • cancer cost over €50 billion in productivity losses due to mortality and morbidity in 2009 and over €20 billion in informal/family care spending (Luengo-Fernandez 2013).

These country-based non health-care costs are reported in Table 2.