Chronic diseases are increasingly common in Western societies where our behaviours, as well as ageing populations, are increasing the risk of long-term morbidity. Chronic diseases are the leading cause of mortality in Europe and the US and can have a significant impact on life-expectancy and years lived in good health. This rise in the prevalence of chronic conditions presents an opportunity to introduce medical devices into the healthcare market which can mitigate both the risk factors and the consequences of these diseases. Here we’ll look at health and care demographics for four European markets (Germany, Italy UK, and France) and the US.
General Health Status
* healthy life years defined as the number of years an individual will live in good health.
Life expectancy across all high-income countries has generally increased over time, but this growth has started to stagnate, notably in the UK and US. The US has the lowest life expectancy of the five markets and its residents are expected to spend fewer years in good health. This could be due to poorer access to, and less well-performing, medical care than the European markets, and a higher rate of risk behaviours (the opioid crisis, for example) which can promote the incidence of poor health and mortality.
*daily smokers aged 15+ as proportion of population
**data sources different to Europe
Risk behaviours such as an unhealthy diet, a lack of physical activity, smoking and binge-drinking are the most common preventable causes of chronic diseases. While the prevalence of smoking and binge-drinking in these markets is generally declining, obesity is increasing rapidly, particularly among adolescents, with childhood obesity a major predictor of future health conditions. Throughout the five markets, 25-44% of each nation’s overall burden of disease can be attributed to behavioural risk factors. This presents an important opportunity for preventative intervention.
The primary causes of mortality and morbidity are equivalent throughout the markets, with cardiovascular diseases, cancers and dementias the most prominent conditions. Interestingly, despite conditions like heart disease being responsible for the greatest number of deaths, mortality rates from these diseases are in fact declining. This contrasts with dementia, where both incidence and mortality rates are increasing.
A Demographic Divide
Unsurprisingly, chronic conditions are most common amongst the elderly, however, deprived populations in the UK experience a 60% higher prevalence, and 30% higher severity of disease, despite very equitable access to health care. The other four markets reflect similar trends in deprivation and regional disparities. This suggests that social and economic circumstance is one of the most important predictors of an individual’s likelihood of suffering from a chronic condition. However, it’s not just socioeconomic status that can influence an individual’s likelihood of developing these diseases; age, ethnicity, family history and co-morbidities are also important determining factors.
* calculated based on data in columns 3 and 4
**includes government expenditure and voluntary/out-of-pocket payments
In 2014, the number of people with a chronic illness in the USA was approximately 42%, which is projected to rise to 47% by 2020, 81 million of whom would have co-morbidities. The US is responsible for the highest health spending in the world (17.2% GDP), of which 75% is spent on chronic conditions. However, chronic conditions and health behaviours don’t appear to be major health priorities for the US, with greater attention given to health insurance reform, drug pricing, value-based care and the opioid crisis.
European markets are investing in initiatives that will more effectively manage ageing populations and improve long-term care for chronic conditions. Public health policies have been introduced in all four European markets to combat unhealthy behaviours. These include schemes in Germany to encourage good nutrition and increase physical activity, tightened tobacco control in Italy and France, and a sugar tax in the UK. France, the UK, and Italy (and even the US) are all working to shift more patients into ambulatory, community, or home-based care.
There are mounting opportunities for medical device manufacturers to investigate the commercial environment of chronic diseases. IDR Medical recognises these opportunities and can support your firm in both investigating the clinical needs of the market, as well as identifying the best way to position your device in this growing field. Please contact us and we would be pleased to offer a primary consultation free of charge.
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