1. Role of Ageing Patients – A Call For Empowerment
20/11/2018
Role of Ageing Patients – A Call For Empowerment
Brussels, 15 May 2012
Alexander Roediger

2. Three Issues Dominating The Debate
Demographic change – decreasing workforce
Increase of chronic diseases, also amongst working age population
Europe’s economic crisis putting pressure on health systems

3. ... while fertility decreases
20/11/2018
Ageing Population Due To Decreasing Fertility and Longer Life Expectancy
Between 2015 and 2035, the population aged 60 and above will be increasing by 2 million people every year …
... while fertility decreases
What does this mean for competitiveness of Europe?
Immediate response:
To increase productivity (health at workplace)
To empower older people’s skills for independent living
Sources: Council of Europe (7/6/2010), Council Concusions on Active Ageing

4. 20/11/2018
... Shrinking Workforce
European working age population is expected to be shrinking between 2020 and 2060 by 13.6%, i.e. 33 million people
"(…) current projections forecast that by 2030, to sustain economic growth, the United States alone will need to add more than 25 million workers to the workforce, and Western Europe will need to add more than 45 million employees” (World Economic Forum, 2010a)
Sources: European Commission (DG ECFIN) and the Economic Policy Committee (AWG) (2009), The 2009 Ageing Report: economic and budgetary projections for the EU-27 Member States ( ), p. 54; World Economic Forum (WEF) (2012), The Workplace Wellness Alliance. Investing in a sustainable workforce; in collaboration with the Boston Consulting Group, p. 5

5. Multiple Chronic Conditions Already In Working Age
20/11/2018
Multiple Chronic Conditions Already In Working Age
Chronic diseases are responsible for 63% of annual deaths, including nearly 50% of premature deaths affecting people under the age of 70 in their productive years
350 million working days are lost in the European Union each year due to illness (issa)
World Economic Forum, referring to WHO, states that chronic diseases are responsible for 63% of annual deaths, including nearly 50% of premature deaths affecting people under the age of 70 in their productive years and concludes that "the disability imposed and the lives lost are also endangering industry competitiveness across borders” (WEF)
Sources: International Social Security Association (issa) (2011), (accessed: 26/02/2012); Bloom, D.E., Cafiero, E.T., Jané-Llopis, E., Abrahams-Gessel, S., Bloom, L.R., Fathima, S., Feigl, A.B., Gaziano, T., Mowafi, M., Pandya, A., Prettner, K., Rosenberg, L., Seligman, B., Stein, A.Z., & Weinstein, C. (2011), The Global Economic Burden of Noncommunicable Diseases. Geneva: World Economic Forum, p. 5

6. Meeting the Maastricht Criteria Will Be Difficult
Sources: Bernstein Research (08/03/2012)

7. Societal and environmental determinants
Health Literacy – The Link Between Better Outcomes And Sustainable Healthcare?
Individual level
Population level
Personal Determinants
Situational Determinants
Life course
Health behavior
Health outcomes
Health service use
Health costs
Knowledge
Motivation
Competences
Access
Understand
Appraise
Apply
Health care
Health promotion
Disease prevention
Health
information
Participa-tion
Empower-ment
Equity
Sustain-
ability
Societal and environmental determinants
Source: Pelikan J et al. (2011), The European Health Literacy Project; findings presented at the European Health Literacy Conference in Brussels on 22/23 November 2011

8. Lower Health Literacy Levels At Higher Age
Source: Pelikan J et al. (2011), The European Health Literacy Projcet; findings presented at the European Health Literacy Conference in Brussels on 22/23 November 2011

9. More Healthcare Use At Lower Health Literacy Levels
Doctor‘s visits
Source: Pelikan J et al. (2011), The European Health Literacy Projcet; findings presented at the European Health Literacy Conference in Brussels on 22/23 November 2011

10. Adherence Is A Complex Problem – Improving Adherence Is An Opportunity
20/11/2018
Adherence Is A Complex Problem – Improving Adherence Is An Opportunity
Average adherence in chronic diseases is only 50% according to WHO
According to a survey of Boston Consulting Group amongst 13,533 patients over 18 years in the US
almost every third patient did not take the medication accordingly
every fourth delayed filling a prescription
every fifth stopped taking a prescription medication sooner than prescribed
… when patients have been at the doctor‘s and got a diagnosis.
According to WHO …
According to BCG …
Lesson to learn
If we want to contribute to better health outcomes for patients we cannot focus on pricing and reimbursement alone
There are many opportunities beyond P&R that
improve the health of patients
make health care more effective
improve and increase the use of our products
Health literacy is a way to get there
Sources: WHO (2003), Adherence to Long-term Therapies. Evidence for Action (Geneva); Boston Consulting Group (BCG, 2003), The Hidden Epidemic. Finding a Cure for Unfilled Prescriptions and Missed Doses; in: USA Today (29/3/2007), Doctors baffled by patients not taking prescriptions ( ); see:

11. Better health outcomes Better use of resources
Empowered Citizens Can Be A Bridge Towards Better Health And Sustainable Healthcare
Better health outcomes
“Health literacy is the capacity to make sound health decisions in the context of every day life.”
Multi-stakeholder programs beyond products to the benefit of patients‘ health
Health Literacy
Better use of resources
Sources: Kickbusch I and Maag D Health Literacy. In: Kris Heggenhougen and Stella Quah, editors International Encyclopedia of Public Health, Vol 3. San Diego: Academic Press; pp

12. Cornerstones To Support Citizens And Patients In Times Of Demographic Change
Citizen/ patient involvement (health literacy) and better coordination of healthcare providers support better health outcomes and contribute to sustainability
Joint effort, i.e. integrated healthcare approach, of all stakeholders needed to meet citizens‘ and patients‘ needs and to improve the „readability“ of the health system
Policies that set the framework and trigger actions