Innovative Funding Models for Non-Communicable Diseases

Introduction

Non-communicable diseases (NCDs) pose a significant health burden globally, especially in low- and middle-income countries (LMICs). These diseases account for 77% of related deaths worldwide, with cardiovascular diseases, cancer, and chronic respiratory diseases being the most prevalent. The disparity in healthcare access between developed and developing nations exacerbates this issue. Economically advanced countries invest more in healthcare due to their financial capacity, unlike LMICs where investment is suboptimal. The Professional Society for Health Economics and Outcomes Research (ISPOR) Arabic Network explored innovative funding models for NCDs in LMICs, focusing on strategies from Morocco, Lebanon, and Egypt.

The Disproportionate Burden of NCDs in LMICs

Dr Rita Karam, Chair of the ISPOR Arabic Network, highlighted the urgent need for innovative funding models at the ISPOR Europe 2023 forum. She pointed out that economically developed nations spend more on healthcare due to their financial capacity. In contrast, LMICs struggle with suboptimal investment and access to healthcare. Dr Karam emphasised the importance of adequate funding and financing for healthcare, which is crucial for achieving Universal Health Coverage (UHC).

Dr Karam introduced several innovative funding models, such as Development Impact Bonds and new tax-based ideas. These models aim to address the unique needs of each country and fill the funding gap for NCDs. Emphasising prevention, early intervention, and improved patient outcomes, she underscored the critical need for these innovative funding solutions.

Morocco: Financing Challenges in Health Innovation

In Morocco, healthcare expenses are growing faster than financial resources. Dr Amal Yassine from the Moroccan Society for Health Products Economics (SMEPS) discussed the challenges Morocco faces. The generalisation of compulsory health insurance has led to a continuous increase in health expenditure. This poses a challenge in strengthening access to quality care and medical services under economic constraints.

Morocco’s elderly population, aged over 60 years, constitutes 12.2% of the demographic, with a life expectancy of 76.7 years. NCD mortality is the leading cause of death in the country. Households bear 46% of the health expenditure burden. The system’s current objective is to optimise available resources to ensure long-term viability. This includes strengthening regulatory tools and integrating therapeutic innovation through health technology assessments (HTAs).

Lebanon: Navigating Healthcare Challenges Amid an Economic Crisis

Lebanon is facing an unparalleled economic crisis, significantly impacting all sectors, including healthcare. Dr Wadih Mina highlighted the country’s efforts to address this crisis through various measures. Lebanon’s currency has depreciated by over 90%, severely limiting the ability to afford healthcare costs, especially for imported consumables priced in foreign currency.

Lebanon’s response includes short-term strategies like the widespread subsidy of imported medicines. Longer-term initiatives involve establishing a universal health coverage law. These measures aim to provide valuable insights for other nations facing similar challenges. Dr Mina invited further research to document Lebanon’s experience and provide insights for other countries.

Egypt: Opportunities for Innovative Health Financing

Healthcare funding in Egypt is fragmented, with multiple sources of funding. Dr Mahmoud Elmahdawy discussed Egypt’s ongoing changes to achieve UHC. The largest healthcare expenditures, approximately 55%, are attributed to NCDs, presenting a significant burden. A high percentage of mortality in Egypt is linked to NCDs.

This underscores the need for a heightened focus on prevention, awareness, and public health campaigns. Further utilisation of HTA principles is essential to optimise healthcare spending. Outcomes-based agreements are currently being explored to encourage systematic evidence-based decisions for healthcare priority setting.

Conclusion

The disproportionate burden of NCDs in LMICs necessitates innovative funding models to address healthcare challenges. Morocco, Lebanon, and Egypt provide valuable insights into the strategies and success stories of implementing these models. Emphasising prevention, early intervention, and improved patient outcomes is crucial for strategies on mitigating the growing burden of NCDs. By adopting innovative funding solutions, LMICs can work towards achieving Universal Health Coverage and improving healthcare access for their populations.