Many health systems in CEE countries lack consistent health-system leadership, adequate funding and digital adoption

• Report writen by the Economist Impact and supported by the American Chamber of Commerce to the EU (AmCham EU) was published in Decemer 2022.

• The purpose of the report was to benchmark access and provision of healthcare services, medicines, healthcare outcomes and quality of care, identifying key gaps within CEE and between the included countries of CEE and western Europe.

• According to the report, healthcare systems in Central and Eastern Europe are facing a number of challenges, including decades of underinvestment, inadequate healthcare infrastructure, shortages of healthcare professionals, and limited access to innovative treatments and diagnostics. The COVID-19 pandemic has further exposed weaknesses in these systems, highlighting the need for prioritizing investment in healthcare and committing to long-term planning to strengthen the resilience of health systems and improve outcomes for patients in the region.

• One of the biggest problem is healthcare spending that is lower in CEE countries both in terms of total healthcare spending per head and as a percentage of GDP (Figure 1). It translates into generally poorer health outcomes and higher amenable and preventable mortality rates. Moreover, there are several problems associated with the current healthcare financing models including the financial burden of out-of-pocket payments on patients, the lack of financial protection for vulnerable populations, and the need for greater investment in healthcare infrastructure and services to meet the changing needs of populations. The report also notes that current financing models are no longer sustainable in the face of changing population demographics, rising economic uncertainty, and a global commitment to moving towards universal healthcare. Failure to prioritize investment in healthcare in the immediate future could further widen the gap with western Europe and exacerbate existing challenges.

• Secondly, there are often rapid changes in ministers of health, which can lead to different opinions and directions in policies, resulting in a lack of big reforms. As many health ministers don't serve a full mandate, quick wins are often prioritized over long-term structural reforms. Small reforms are implemented but not consistent, resulting in a lot of complexity.

• According to the authors' findings, patients in CEE countries face significant challenges in accessing innovative medicines and technologies, particularly for cancer and non-communicable diseases. Patients in CEE countries wait significantly longer for access to innovative treatments and have access to a much smaller pool of approved innovative drugs than those in western European countries, leading to higher mortality, avoidable deaths, and avoidable healthcare costs. The causes that limit access in CEE countries are complex, ranging from cost-containment measures and regulatory processes to reimbursement complications and budget constraints, among many others.

• Finally, the adoption of digital health solutions in CEE is still unevenly developed, with significant variations in infrastructure readiness, internet access and speed, availability of qualified ICT specialists, legal and data privacy frameworks, and the willingness and ability of healthcare workers and the population to use digital tools. While the pandemic has accelerated the adoption of telehealth and virtual care, there is still a clear gap between CEE countries and western European counterparts in terms of digital readiness.

• The whole report is available here.