Most expensive diseases getting more expensive

Marcus Pickett

The World Economic Forum’s latest report on the global cost of the most expensive non-communicable diseases — and the top five have a nearly $50 trillion price tag. That’s going to leave nations (and patients) struggling to pay the bill for years to come.

Deadly and expensive

Non-communicable diseases (in other words, diseases that aren’t contagious) are responsible for 60 percent of deaths worldwide. In terms of economic costs, however, five diseases in particular stand out:

• Heart disease.
• Chronic respiratory disease.
• Cancer.
• Diabetes.
• Mental illness.

Over the next two decades, these diseases are expected to cost $47 trillion, or 4 percent of global GDP, according to the World Economic Forum. Of these diseases, the forum predicts that mental illness will account for one-third of the total loss, or $16 trillion. Cardiovascular disease, meanwhile, is expected to cost nearly $20 trillion.

Growing costs

Only a portion of the total cost of non-communicable diseases is related to health care and treatment, according to the World Economic Forum. A significant amount of the economic cost is actually lost productivity and economic output. In other words, if people are too sick to work, their nations’ economies lose money.

According to the report, 40 percent of the costs of non-communicable diseases affect non-health-related areas of society. The biggest players are mental illnesses and cardiovascular disease, accounting for 70 percent of the lost output. And the problem is accelerating. The World Economic Forum predicts that losses will rise steadily over the next 20 years and pick up sharply by 2030. Between 2010 and 2030, the value of lost lives, lost incomes and health care costs is expected to double.

Taken as a whole, the rising economic costs of the most expensive diseases may contribute to a future global recession. The numbers suggest that non-communicable diseases have “the potential to not only bankrupt health systems but to also put a brake on the global economy,” Olivier Raynaud, senior director of health at the World Economic Forum, says in a news release on the forum’s website.

‘Best buy’ interventions

Just throwing money at the problem is not the solution, according to a 2011 World Economic Forum report called “From Burden to ‘Best Buys’: Reducing the Economic Impact of Non-Communicable Diseases in Low- and Middle-Income Countries.” Instead, the report proposes interventions that seem to show the best return on investment — “best buy interventions,” as the report calls them.

Among the suggested interventions are:

• Tax increases on unhealthy products like cigarettes.
• Campaigns that discourage the use of tobacco and harmful use of alcohol.
• Public awareness programs about the dangers of unhealthy diets and lack of physical activity.
• More consistent counseling, screenings and treatment for heart disease and cancer. If diseases are caught earlier, treatment is less expensive.

These interventions, according to the forum, would pay for themselves many times over. The report claims, for example, that reducing the death rate for ischaemic heart disease and stroke by 10 percent would reduce economic losses in low-and middle-income countries by $25 billion a year. That’s three times more than the cost of carrying out the report’s suggestions.

Insurance coverage for expensive diseases

While chronic diseases are expensive for nations, they can be financially draining for the people affected by them. But unless someone already has health insurance when the diagnosis is made, it’s often difficult or impossible to get coverage for the most expensive diseases. Group health insurance plans (coverage through an employer) are more likely to offer coverage for those with chronic illnesses. But insurance plans on the individual market generally will reject applicants who have diseases that will cost the insurer a lot of money.

The health care reform law, however, has changed the game for some. If the 2014 health insurance mandate is not overturned, health insurance companies will be required to extend coverage to all applicants regardless of pre-existing conditions.

For now, those who have chronic conditions and no health insurance coverage can turn to the Pre-Existing Condition Insurance Plan. Established under the health care reform law, this high-risk health insurance pool provides coverage to those who have been denied insurance and who have been without it for at least six months. Some states operate their own pools, while other states have turned theirs over to the federal government.

However, this last-ditch option still is no bargain. In fact, the U.S. Department of Health and Human Services decided to lower the premiums for these high-risk pools to encourage a higher participation rate, as many people found they simply couldn’t pay for the original premiums.