The health sector in the European Union
Policymakers across the EU are facing vast societal challenges related to population health such as an increased life expectancy and ageing population, health inequalities, and wasteful health spending.
- The European population is ageing fast. In 2017, the share of persons over 65 years old in the European Union was 19.4%, this percentage will rise to 28.5% in 2050 (see Figure 1). In the European Union, the share of persons aged 65 or older in the total population range from 22.3% in Italy to 13.5% in Ireland (see Map 1). The ageing population will translate into different demands for health-related products and services and requiring an overall reorganisation of leisure.
- The life expectancy at birth reached 81 years across the 28 EU member states in 2016 (OECD/EU, 2018). The promotion of healthy ageing is thus a growing policy priority.
- There are still large inequalities in life expectancy in the European Union, with the highest in Spain, 83.5 years, and the lowest in Lithuania, 74.9 years. More than 1.2 million deaths could have been avoided in EU countries in 2015 through better public health policies or more effective and timely health care (OECD/EU, 2018).
- In 2017, spending on health care in the European Union stood at 9.6% of gross domestic product, ranging from over 11% in France and Germany to less than 6% in Romania. However, the OECD/EU finds that “evidence from various countries suggests that up to one-fifth of health spending is wasteful and could be reallocated to better use” (OECD/EU, 2018). Wasteful spending occurs when patients receive unnecessary tests or treatments or when care could have been provided with fewer and less costly resources.
Figure 1. The share of persons over 65 years old in the European Union in 2017 and 2050. Source: EC, 2019.
Map 1. The share of persons aged 65 or older per country in the European Union. Sources: EC, 2019.
To face these challenges, the health sector offers many opportunities for research and innovation in the EU. Being a high growth sector in terms of employment, with a net increase of 1.8 million jobs across the EU between 2013 and 2025 (EC, 2014), it is also a highly innovative sector. In 2016, the European Patent Office (EPO) received a total of 12,263 patent applications for medical technologies; 41% from Europe and 38% from the US. Germany is leading with 11% of all medical technology patent applications, followed by the Netherlands (7%), Switzerland (5%) and France (4%) (EPO, 2016).
Interreg Europe projects in the health sector
8 Interreg Europe projects focus on policies related to health. They are dedicated to find solutions to complex challenges and to leverage on interregional cooperation opportunities to potentially generate breakthrough innovations in the health sector.
Healthy ageing is one of the main topics covered: EU_SHAFE focuses on smart and health age-friendly environments, and INNOVASPA partners exchange on innovative solutions through thermal spa services. The challenge of wasteful spending is instead the main objective of HELIUM, Health Innovation Experimental Landscape through Policy Improvement, and partially of HOCARE, whose focus is on improving healthy ageing and reduce wasteful spending by enabling users, businesses, research actors/universities and public authorities work together to find solutions to complex challenges through quadruple helix cooperation.
Three more projects deal more specifically to healthcare policies related to the promotion of products and services: this is the case of INTENCIVE, INnovation and Technology ENhancing Customer OrIented Health SerVicEs; ITHACA, InnovaTion in Health And Care for All, promoting smarter policies to generate product and service innovations, and TITTAN, Network for Technology, Innovation and Translation in Ageing. One last project, Medtech4 Europe, aims to optimise the impact of public policies in favour of research and innovation facilities in the field of medical technologies, aiming to leverage on interregional research opportunities to generate product innovations in medical technologies and reduce healthcare costs.
The 8 Interreg Europe projects in the health sector have generated an important number of good practices. Below are four examples of such good practices. They are grouped according to the policy challenges they are trying to address.
The first important policy challenge is to promote the acceleration of the innovation process in the health sector as it is prone to many market failures. The projects TITTAN and HELIUM show possible paths to move forward.
In the TITTAN project, PRIS is a programme to boost the pre-commercialisation of research results from the Galician Public Health System. Ultimately, it aims to accelerate the commercialisation of research projects with potential market application. Its unique feature lays on the fact that it is open to the entire health system (researchers, nurses, etc.), to all technologies (drugs, diagnostics, devices, etc.) in all readiness levels (proof of concept, prototype, etc).
According to Arnault Morisson, Thematic Expert in Research and Innovation for the Interreg Europe Policy Learning Platform, “this is an initiative that would benefit regions with weak to moderate university-industry collaboration and a low rate of spin-offs creation that aim to accelerate pre-commercialisation processes of research results”.
In the HELIUM project, CrossCare is a programme that provides funding and support services for SMEs and entrepreneurs to accelerate the commercialisation of innovative health products and services. The programme involves 6 living labs dedicated to health in the Netherlands and Flanders (Belgium). For SMEs and entrepreneurs, it offers the opportunity for interregional learning and understanding the end-users’ needs of two neighbouring countries. Through this interregional component, the programme aims thus to accelerate commercialisation and SMEs’ internationalisation. This is a good example showing that living labs and SMEs from different countries can collaborate efficiently on complex health projects.
In the HELIUM project, the HAITool is a toolkit to Prevent, Manage and Control Healthcare Associated Infections in the context of increased antibiotic resistance. HAITool stresses the importance of co-creation between researchers and professionals when developing such initiatives. The good practice reduces the unnecessary use of antibiotics and thus wasteful spending. This is a very flexible tool, as it is currently being adopted in countries with different institutional contexts, namely Cape Verde, Norway, and Switzerland, demonstrating its transferability and possible wider adoption in other countries.
In the HOCARE project, TELEHIPPOCRATES is a telemedicine programme in Nicosia, Cyprus. Telemedicine programmes are being put in place in different regions and countries across the EU. However, this programme is particularly interesting compared to others, due to its low financial cost for implementation – contributing to a very high transferability potential. Also, its history is peculiar: at its testing phase, it was financed by a European Territorial Cooperation cross-border programme. With time it became so successful that the service was integrated in the Nicosia General Hospital as a standard programme. Durability and efficacy are therefore clear assets of this practice.
Some of the good practices in the health sector from Interreg Europe have been widely recognised in the European Union. From this recognition, HOCARE has been nominated for the 2019 RegioStars Awards competing in modernising health services. The RegioStars Awards will be granted during The European Week of Regions and Cities on Thursday 10 October 2019.
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