Eastern European Business and Economics Journal

Long Term Health Spending Alongside Population Aging in N-11 Emerging Nations

 

 

Nemanja Rancic, Mihajlo (Michael) Jakovljevic

 

Rancic N, Jakovljevic M. 2016. Long Term Health Spending Alongside Population Aging in N-11 Emerging Nations. Eastern European Business and Economics Journal 2(1): 2-26.

 

Full text

 

Reviewers:

 

Uldis BERĶIS, Rīgas Stradiņa Universitāte, Latvia;

Piotr ROMANIUK, Medical University of Silesia in Katowice, Poland;

Rumen STEFANOV, Medical University of Plovdiv, Bulgaria.

 

Abstract:

The rise of “emerging markets” is one of the key changes that is causing the global economic situation to unravel. The Next Eleven (Next-11) countries are known as the second-tier group of “emerging economies” behind the BRICS. Regardless of their diverse socio-geographical characteristics, the Next-11 countries have similarities pointing out to their high economic potential. The paper presents long-term differentials of accelerated population aging and corresponding health expenditure in the Next-11 nations from 1995 to 2013. An increase in the proportion of the elderly population, coupled with falling fertility rates, led the Next-11 countries to increase health care expenditures. Total health spending, expressed as a percentage of gross domestic products, gives clear evidence of growth. Private expenditure on health has been undergoing constant increases in recent years, driven primarily by out-of-pocket spending. Regardless of different health care financing mechanisms, all Next-11 health systems appear to withstand a heavy burden of an aging population, threatening their fiscal sustainability in the upcoming decades.

 

Keywords:

Next-Eleven countries, Health care expenditure, Medical Spending, Population Aging, N-11, Emerging Markets, Trend analysis

 

JEL classification:

I15, P52, J11

 

Language:

English

 

References:

Akinbosoye, O., Matlin, O.S., Mostovoy, L., Brown, F., Szychowski, J.A. (2012). Conventional and Biologic Rheumatoid Arthritis Therapies: Utilization and Cost Trends. Retrieved March 20, 2015, from: http://www.ajmc.com/publications/ajpb/2012/AJPB_NovDec2012/Conventional-and-Biologic-Rheumatoid-Arthritis-Therapies-Utilization-and-Cost-Trends.

Alpern, J.D., Stauffer, W.M., Kesselheim, A.S. (2014). High-cost generic drugs--implications for patients and policymakers. The New England Journal of Medicine, 371 (20), 1859-1862.

American International Group, Inc. (2012). Emerging Markets - Next 11 line up as untapped markets. Retrieved March 12, 2015, from: http://www.aig.com/Multinational-next-11_2538_438271.html.

Cancer Research UK. (2014). Saving lives, averting costs: An analysis of the financial implications of achieving earlier diagnosis of colorectal, lung and ovarian cancer. Report for Cancer Research UK  by Incisive health.

Colombo, F., & Tapay, N. (2004). Private Health Insurance in OECD Countries: The Benefits and Costs for Individuals and Health Systems. France: OECD. Retrieved March 30, 2015, from: http://www.oecd.org/els/health-systems/33698043.pdf.

Eriksson, J.K., Karlsson, J.A., Bratt, J., Petersson, I.F., van Vollenhoven, R.F., Ernestam, S., Geborek, P., Neovius, M. (2015). Cost-effectiveness of infliximab versus conventional combination treatment in methotrexate-refractory early rheumatoid arthritis: 2-year results of the register-enriched randomised controlled SWEFOT trial. Annals of the Rheumatic Diseases, 74 (6), 1094-1101.

European Commission (DG ECFIN)-EPC (AWG). (2012). The 2012 Ageing Report – Economic and budgetary projections for the 27 EU Member States (2010-2060). European Economy, No 2/2012.

Fragoulakis, V., Raptis, E., Vitsou, E., Maniadakis, N. (2015). Annual biologic treatment cost for new and existing patients with moderate to severe plaque psoriasis in Greece. Clinicoecon. Outcomes. Res, 7, 73-83.

Gerber, D.E. (2008). Targeted therapies: a new generation of cancer treatments. Am. Fam. Physician, 77 (3), 311-319.

Global Health Expenditure Database (GHED). (2011). Retrieved April 06, 2015, from: http://www.who.int/health-accounts/ghed/en/.

Government Accountability Office. (2009). Brand-name prescription drug pricing: lack of therapeutically equivalent drugs and limited competition may contribute to extraordinary price increases. Retrieved March 19, 2015, from: http://www.gao.gov/new.items/d10201.pdf.

Greß, S. (2007). Private Health Insurance in Germany: Consequences of a Dual System. Healthcare Policy, 3 (2), 29-37.

Herper, M. (2010). The world’s most expensive drugs. Retrieved March 20, 2015, from: http://www.forbes.com/2010/02/19/expensive-drugs-cost-business-healthcare-rare-diseases.html.

Jacobsen, L.A., Kent, M., Lee, M., Mather, M. (2011). America’s Aging Population. Population. Bulletin, 66(1).

Jakovljevic, M.B. (2015a). BRIC’s growing share of global health spending and their diverging pathways. Frontiers in Public Health, 3:135. 10.3389/fpubh.2015.00135

Jakovljevic, M. (2015b). Comparison of Historical Medical Spending Patterns among the BRICS and G7. Journal of Medical Economics, 19, 70–77. 10.3111/13696998.2015.1093493.

Jakovljevic, M. (2015c). The aging of Europe. The unexplored potential, Farmeconomia. Health economics and therapeutic pathways, 16(4), 89-92.

Jakovljevic, M.B. (2015d). Targeted immunotherapies overtaking emerging oncology market value based growth. JBUON, 20(1), 348-353.

Jakovljević, M.B. (2014a). Recent developments in the world's leading generic markets. Medicinski Časopis, 48(3), 140-142.

Jakovljevic, M., (2014b). Oncology monoclonal antibodies expenditure trends and reimbursement projections in the emerging Balkan market. Farmeconomia. Health economics and therapeutic pathways, 15(1), 27-32.

Jakovljevic, M., Getzen, T. (2016). Growth of Global Health Spending Share in Low and Middle Income Countries. Frontiers in Pharmacology, 7:21 10.3389/fphar.2016.00021

Jakovljevic, M., Groot, W., Souliotis, K. (2016a). Health care financing and affordability in the emerging global markets. Frontiers in Public Health, 4:2. 10.3389/fpubh.2016.00002.

Jakovljevic, M., Vukovic, M., Fontanesi, J. (2016b). Life Expectancy and Health Expenditure Evolution in Eastern Europe - DiD and DEA analysis. Expert Review of Pharmacoeconomics&Outcomes Research, 10.1586/14737167.2016.1125293

Jakovljevic, M., Laaser, U. (2015). Population aging from 1950 to 2010 in seventeen transitional countries in the wider region of South Eastern Europe. SEEJPH, DOI 10.12908/SEEJPH-2014-42.

Jakovljevic, M., Nakazono, S., Ogura, S. (2014). Contemporary generic market in Japan – key conditions to successful evolution. Expert Review of Pharmacoeconomics&Outcomes Research, 14(2), 181-194.

Jakovljevic, M., Zugic, A., Rankovic, A., Dagovic, A. (2015). Radiation Therapy Remains The Key Cost Driver Of Oncology Inpatient Treatment. Journal of Medical Economics, 18(1), 29-36.

Karaca-Mandic, P., McCullough, J.S., Siddiqui, M.A., Van Houten, H., Shah, N.D. (2011). Impact of new drugs and biologics on colorectal cancer treatment and costs. Journal of Oncology Practice, 7(3 Suppl), e30s-37s.

Kinsella, K., Velkoff, A.V. (2001). U.S. Census Bureau, Series P95/01-1. An Aging World: 2001. U.S. Government Printing Office, Washington, DC. Retrieved March 18, 2015, from: http://www.census.gov/prod/2001pubs/p95-01-1.pdf.

Kovacevic, A., Dragojevic-Simic, V., Rancic, N., Jurisevic, M., Gutzwiller, F., Matter-Walstra, K., Jakovljevic, M. (2015). End-of-life costs of medical care for advanced stage cancer patients. Vojnosanit Pregl, 72(4), 334-341.

Lichtenberg, F.R., Tatar, M., Çalışkan, Z. (2014). The effect of pharmaceutical innovation on longevity, hospitalization and medical expenditure in Turkey, 1999-2010. Health Policy, 117(3), 361-373.

Lutz, W., Sanderson, W., Scherbov, S. (2008). The coming acceleration of global population aging. Nature, 451, 716-719.

Maisonneuve, C., Martins, J.. (2006). The drivers of public expenditure on health and long-term care: an integrated approach. OECD Economic Studies, No 43.

Mendelson, D.N., Schwartz, W.B. (1993). The effects of aging and population growth on health care costs. Health. Aff. (Millwood), 12(1), 119-125.

Micromedex healthcare series. (2015). Retrieved March 20, 2015, from: http://www.thomsonhc.com/hcs/librarian.

Mokari, D. (2015). Next-11 Emerging Markets. Retrieved March 11, 2015, from: http://next11.se/next-11-emerging-markets/.

National Institutes of Health. U.S. Department of Health & Human Services. (2011). Global Health and Aging. World Health Organization. Retrieved March 18, 2015, from: http://www.who.int/ageing/publications/global_health/en/.

Ogura, S. (1994). The cost of aging: Public finance perspectives for Japan. In: Aging in the United States and Japan: Economic Trends. Chicago: University of Chicago Press, 139-174.

Ogura, S., Jakovljevic, M., (2014). Health financing constrained by population aging- An opportunity to learn from Japanese experience. Serbian Journal of Experimental and Clinical Research, 15(4), 175-181.

Schrag, D. (2004). The price tag on progress-chemotherapy for colorectal cancer. The New England Journal of Medicine, 351(4), 317-319.

Sekhri, N., & Savedoff, W. (2004). Private health insurance: implications for developing countries. Geneva: World health organization. Retrieved March 30, 2015, from: http://www.who.int/health_financing/documents/dp_e_04_3-private_h_insurance.pdf.

Sghari, M.B.A., & Hammami, S., (2014). The impact of aging on health care expenditure in developed countries. Impact. Journals, 2(2), 53-62.

Shaughnessy, A.F. (2012). Monoclonal antibodies: magic bullets with a hefty price tag. BMJ, 345, e8346.

Shepard, A. (2010). Generic medicines: essential contributors to the long-term health of society. Sector sustainability challenges in Europe. Danbury: ims health. Retrieved April 20, 2015, from: http://www.imshealth.com/imshealth/Global/Content/imS%20institute/Documents/Generics_medicines.pdf.

Sizto, S., Bansback, N., Feldman, S.R., Willian, M.K., Anis, A.H. (2009). Economic evaluation of systemic therapies for moderate to severe psoriasis. Br. J. Dermatol, 160(6), 1264-1272.

The World Bank. (2013). Data: Out-of-pocket health expenditure (% of private expenditure on health). Retrieved March 30, 2015, from: http://data.worldbank.org/indicator/SH.XPD.OOPC.ZS.

UpToDate. (2015). Lexi-Comp's comprehensive drug-to-drug, drug-to-herb and herb-to-herb interaction analysis program. Retrieved March 20, 2015, from: http://www.utdol.com/crlsql/interact/frameset.jsp.

Velkoff, V.A., & Kowal, P.R. (2007). Population aging in Sub-Saharan Africa: demographic dimensions 2006. US Department of Commerce, Economics and Statistics Administration, US Census Bureau, 7(1).

Wasem, J., Greß, S., Okma, K.G.H. (2004). The Role of Private Health Insurance in Social Health Insurance Countries. In: Saltman, R., Busse, R., Figueras, J., editors. Social Health Insurance in Western Europe. London: Open University Press, 227–247.

World Health Organization. (2013a). Countries. Retrieved March 11, 2015, from: http://www.who.int/countries/en/.

World Health Organization. (2013b). Life expectancy. Data by country. Retrieved March 18, 2015, from: http://apps.who.int/gho/data/node.main.688.