Investing in health: Will Portugal’s recent election results help prevent an epidemic of chronic diseases?
With the start of a new legislature and backed by a strong political majority, the new Portuguese government is poised to deliver on election promises. The re-appointed Health Minister Marta Temido has the opportunity to ensure that the healthcare system has the necessary funding to target the backlog of consultations, diagnoses, and treatments of chronic diseases created by the pandemic as well as to ensure access to innovation for patients in Portugal.
The Portuguese electorate has been clear in their choice. Faced with the question of who should lead the country out of the COVID-19 pandemic crisis, they were categorical in their desire for political stability and continuity. The Socialist Party (PS), which has governed for the past 6 years through a left-wing coalition, received a vote of confidence by the public and was rewarded with an absolute majority, allowing it to govern alone and push through its campaign agenda. How can PS harness this momentum to improve healthcare outcomes beyond pre-pandemic levels?
Present and future of healthcare in Portugal
Portugal and its National Healthcare System (NHS) were exemplary in combating the pandemic, reaching an extremely high vaccination coverage – at one point the highest in the world and still the highest in the EU . Unfortunately, this does not reflect the overall status of healthcare in Portugal. On average, only 51% of the medicines that received marketing authorisation (MA) at European level between 2017 and 2020 are available in Portugal. Furthermore, patients wait an average of 676 days for access to new medicines after marketing authorization and even then, a quarter of the medicines available have additional restrictions on reimbursement, excluding specific groups of patients .
Throughout the pandemic, patients have struggled across Europe to get optimum care for conditions other than COVID-19. The fear of infection has driven many away from hospitals, which has led to delayed diagnoses and, as conditions worsened, poorer prognoses . The seriousness of this situation in Portugal is clear:
The European Cancer Organisation estimates that almost 40% of cancer patients had to stop their cancer treatment in 2020 due to COVID-19 .
Over 50% of medical activities (consultations, surgeries, exams) were postponed.
Between March 2020 and November 2021, there were 13 million less face-to-face contacts in primary healthcare than expected, 500,000 surgeries were cancelled and there were 3.8 million emergency episodes and 1.2 million admissions less than in 2019.
In 2020, newly diagnosed diabetes cases decreased by 23% and by 62% for obesity.
We are now at risk of facing a different kind of crisis: an epidemic of non-communicable diseases (NCDs).
The need for investment, the need for health
The PS electoral programme, outlines that the NHS faces various challenges, requiring it to adapt and reinvent itself, to promote health, and to prevent illness in all citizens. Portugal needs more investment in healthcare and a health policy with innovation as its backbone to ensure access to innovative treatments and delivery of better clinical outcomes, aligned with the patient’s needs. These long-term investments will help lead to better health outcomes and future savings with less complications from long-term conditions, less emergency costs, and consequently, better productivity and economic output for the country.
One example is obesity. Portugal has the opportunity to continue the work started in 2004 with the publication of its National Obesity Plan, by following the national Parliament’s resolution in mid-2021 asking the Government to invest more in literacy, prevention, and screening for obesity. The goal here is also to increase treatment capacity at obesity treatment centres to make up for COVID-related backlogs and to create a specific subgroup/pathway for pharmaceutical treatments. Obesity is a risk factor for type 2 diabetes, cardiovascular disease and certain cancers, making it the 5th leading cause of death worldwide. Across Europe, it has been estimated to cost the EU €70 billion annually due to healthcare costs and lost productivity.
The PS’ commitment in its programme to continue developing the current innovation policy on access to new medicines and their 2022 State Budget proposal, would help reinforce the NHS's budget with €700 million to hire additional healthcare professionals and quickly return to the level of care provided before the pandemic. We believe this type of investment should focus on improving healthcare outcomes consistently, going beyond pre-pandemic levels, not just matching them.
How can industry help?
Lilly, in partnership with the other member companies of our European trade association, EFPIA, is committed to doing its part and to working with the different stakeholders to speed up patient access to new medicines well below the current 676 days. We have committed to file for pricing and reimbursement as fast as possible, and within 2 years of MA, as well as to track this through a portal. Only by working together, can we help ensure equitable, sustainability access for all citizens in Portugal, and beyond.
 Coronavirus (COVID-19) Vaccinations - Our World in Data – checked on 30 March 2022
 EASO, ‘ Key Messages’, https://woday.eu/wp-content/uploads/2023/01/230130-Messaging-final.pdf
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