Mitigating the impact of the NCD burden

The challenges posed by noncommunicable diseases (NCDs) are stark. They are the world’s number one killer, accounting for the single greatest cost to the NHS1 and have a direct impact on economic productivity.2 NCD morbidity rates are only set to increase as populations age and unhealthy lifestyles spread. Innovative technology which can mitigate the impact of NCDs already exists. However, with health service providers in the UK facing immediate pressures to cut costs, it is critical that investment in these technologies is not inhibited by concern surrounding the immediate capital investment. Instead this must be weighed against the much greater long-term costs for healthcare provision and the wider economy if nothing is done.

A growing challenge

NCDs are diseases of long duration, generally slow progression and are typically non-infectious. They often bear a heavy burden of associated additional disorders or diseases (‘comorbidities’), and include illnesses such as diabetes, musculoskeletal diseases, many cancers, chronic respiratory disease, cardiovascular disease and neuropsychiatric conditions like dementia. The scale of the NCD challenge is staggering. They account for two out of three deaths globally, and in Europe, NCDs kill more people each year than all other causes combined, they are responsible for 86% of all deaths.3 In addition to impacting NCD sufferers and their families, the burden on health services is significant. In the UK, the biggest cost to the NHS is looking after people with a chronic disease. It is estimated that £7 of every £10 spent on the NHS health budget goes towards supporting people living with a chronic condition.4 Furthermore, these sufferers use half of all GP appointments and 70% of inpatient bed days.5 NCDs also pose a burden on the economy more widely because those suffering from these conditions can be less able to work and stay active. According to The Global Economic Burden of Non-Communicable Diseases, a report by the World Economic Forum and Harvard School of Public Health, half of those who die of chronic NCDs are in their prime productive years. For example, musculoskeletal diseases account for a greater proportion of sickness absence from work than any other health condition, costing an estimated ?240bn annually to the economy in Europe alone.6 The totality of indirect social costs relating to NCDs is significant, and can be larger than the direct healthcare costs. Looking to the future, European healthcare systems face multiple challenges such as those related to treatments of complex diseases, taking care of an ageing population and the ageing of the health workforce itself. If we continue with today’s treatment-based healthcare model, the predictions of an unprecedented escalation in costs and demand are formidable. There has never been a greater clinical need to develop new health strategies that can drive healthcare efficiencies and improve clinical benefit for people, but few appreciate that such investment reaps not only clinical benefits but also can drive economic prosperity. Given that the key drivers of NCDs are ageing populations and unhealthy lifestyle behaviours such as physical inactivity, unhealthy diet and harmful use of alcohol,7 NCD prevalence looks set to be the challenge for governments looking to improve healthcare and drive economic growth.