10 Jun 2021

An increasing number of European citizens are aged over 65 and they are living longer. An ageing population presents many complex, interrelated issues, from pensions and jobs to infrastructure and social cohesion.1 It also sits at the intersection of today’s most pressing healthcare policy issues.

The EU institutions are taking note. The European Commission published its Green Paper on Ageing in January this year. In the European Parliament, there are two reports on demographic change being discussed. However, these developments are intended to stoke discussion and will not necessarily lead to any concrete policy change.

What could the pharmaceutical industry and other interested stakeholders think about in the meantime, within existing Commission policy initiatives?

Current action by policymakers

The Commission’s centrepiece on this topic is the Green Paper on Ageing. A Green Paper is a report that is published by the Commission to start a public debate. Unlike a White Paper, it does not lead to a legislative proposal. The aims of the Ageing Green Paper are to set out the key issues related to ageing and discuss possible ways of anticipating and responding to this demographic change. A public consultation on it closed at the end of April 2021.

Healthcare is a central pillar, with issues identified including the promotion of healthy lifestyles to protect against avoidable illness, the expected increase in demand for healthcare as the population ages, challenges in long-term care for the elderly around access, affordability, quality and staffing, and regional disparities in vital infrastructure such as physical access to medical services.

In parallel, the Employment and Social Affairs (EMPL) and Regional Development (REGI) Committees of the European Parliament have each prepared a report on demographic change. REGI’s report was adopted by the Parliament in May 2021 and has been forwarded to the Commission for consideration. While the reports shape the policy discussions and provide Members of the European Parliament (MEPs) with a platform to outline recommendations, again, they will not change anything in themselves.

What could the pharmaceutical industry and others do now?

With its current focus on health, and as the EU’s executive body and agenda-setter, the Commission is the key player in instigating policy change.

There are several existing policy levers and initiatives that stakeholders could engage with to improve outcomes for older communities now, rather than waiting for a dedicated solution to come from Brussels:

  • Affordability and availability of medicines

With more citizens requiring medication for age-related conditions, there will be added pressure on budgets. An ageing population means fewer citizens of working age, posing the possibility of further budget deficits.

Affordability of healthcare is a cornerstone of the Commission’s current overhaul of the EU’s pharmaceutical legislation, with proposals under public consultation around availability of generics and biosimilars seen as one way to reduce healthcare costs.

Stimulating competition through innovative new treatments is also important. The Commission is trying to facilitate the removal of barriers to bring new therapies like Advanced Therapeutic Medicinal Products to patients, through the introduction of the proposed Health Technology Assessment Regulation (which is now in trialogue discussions)2; but further work can be done.

  • Healthy ageing

Around 37% of people aged 65 and older have at least two chronic conditions. Chronic diseases, like cardiovascular disease (CVD), Alzheimer’s and cancer, may be linked to lifestyle factors and are — to varying degrees — preventable. Encouraging a healthy, active lifestyle and routine screening to allow for earlier interventions are crucial in supporting healthy ageing and preventing complications of co-morbidities.

There is already a push to combat some chronic non-communicable diseases, for example the Commission’s flagship Beating Cancer Plan which has strong backing from MEPs (see our blog on this topic). A European Parliament interest group to tackle obesity was formed in April 2021. Similar initiatives could be developed for other non-communicable diseases that disproportionately affect older people, like CVD and Alzheimer’s.

  • Access to care

Access to care is not equal across the EU. The OECD has also raised concerns around older people accessing support in the context of the COVID-19 pandemic. Healthcare infrastructure needs to take advantage of technology, connecting patients with care providers and equalising access. As Commissioner Kyriakides recently stated, “Digital technologies have great potential to facilitate better access to healthcare.”

Now is the time to ensure that the existing work on EU healthcare reflects all views and will improve the experience and potential outcomes for older citizens in Europe.

One solution would be the creation of the EU Health Data Space. A consultation was launched in early May 2021 by the Commission. It is intended to facilitate electronic medical records, ease transfers of data, and better integrate technology into care and treatment in the EU. This could support more cross-border healthcare, offering flexibility when deciding how and where to be treated.

Another potential solution is to unlock funding for digital infrastructure to facilitate online medical care in home settings, with parallel investment in digital health literacy for immobile communities. Commissioner Kyriakides has acknowledged the importance telehealth played for patients during the pandemic. This trend is expected to continue, with one survey suggesting that 71% of healthcare leaders in the Netherlands count a shift to remote/virtual care among their priorities for the future.

The wealth of initiatives – both legislative and non-legislative – underscores that the ageing debate cannot be siloed as it impacts, and is impacted by, broader healthcare policies. Together they present an opportunity to take swift action from many angles, hooking into other work by engaging in relevant consultations and discussions to ensure views on the ageing debate are heard in all forums.

Interested parties should proactively advocate for necessary change on ageing now, through existing legislative and non-legislative initiatives, rather than waiting for a potential Commission White Paper, or other non-legislative proposal.

Now is the time to ensure that the existing work on EU healthcare reflects all views and will improve the experience and potential outcomes for older citizens in Europe.

1. hhttps://ec.europa.eu/info/law/better-regulation/have-your-say/initiatives/12722-Demographic-change-in-Europe-green-paper-on-ageing_entps://www.economist.com/international/2021/05/22/how-the-pandemic-has-upended-the-lives-of-working-parents
2. https://www.europarl.europa.eu/legislative-train/theme-deeper-and-fairer-internal-market-with-a-strengthened-industrial-base-products/file-health-technology-assessment