Since the Brazilian Regulatory Agency for Supplementary Health’s (ANS) creation in 2000, health insurance inflation has grown at a much greater pace than general inflation. Indeed, after eighteen years the private health insurance price index was close to double the official inflation index, with its 382% (see here).
The upward course of prices can be interpreted as a response to the problems arising from the escalating costs. Baumol (2012) calls this phenomenon “cost disease”, designating that labor relates differently to production: in the case of the goods, work would be incorporated into the product; in the case of services, labor would be the product being exchanged, making difficult to substitute factors.
Unlike other epidemics or pandemics – such as tuberculosis, SARS, MERS or HIV/AIDS – COVID-19 has hit hardest at the world’s wealthiest countries. As of early June 2020, the 37 industrialized countries of the OECD accounted for 59% of all cases and 78% of deaths, even though they constitute less than 18% of the total population affected.
Looking at the pandemic’s effects in another way – using cases and deaths per million population – paints an even starker picture. OECD countries have a prevalence ratio of 2,890 cases per million and a mortality rate of 225 per million, compared with 869 cases and 51 deaths per million in the rest of the world. Furthermore, the case fatality ratio (CFR) – the ratio of deaths to cases – is also higher in the OECD (7.8%) than in the rest of the world (5.9%).
What can explain this phenomenon, the world’s richest countries impacted more than middle-income and poor countries? One explanation is that COVID-19 spreads faster in countries that are more integrated to the globalized economy, as the OECD members certainly are. A recent study found that globalized countries have indeed experienced more cases per population, but less mortality.Read More »
September’s UN special session on antimicrobial resistance (AMR) was a vivid reminder of the shared responsibility of governments to promote research and development (R&D) combat global health threats. The complexity of the AMR threat made clear that a combination of market forces, policy incentives, and regulation, as well as norms and standards was needed to ensure innovation that would deliver accessible and affordable treatments.
The report of the UN Secretary-General’s High-Level Panel on Access to Medicines offers an important opportunity for national governments, UN organizations, philanthropies, civil society, and pharmaceutical manufacturers to move forwards and address this challenge. AMR is just the latest global health priority that cannot be resolved with the current incentive system for investing in medical R&D. AMR threatens to render a whole range of treatments ineffective and reverse 20th century advances in medicine. Numerous other health priorities are neglected because they do not present a business potential for investment, and millions of people lack access to medicines and treatments that are priced out of reach.
In a world of unprecedented medical advances, these unmet needs present a moral dilemma, and one of the most critical challenges for humanity. The Panel, on which I had the privilege to serve, makes a number of concrete proposals to promote needs-driven R&D financing and to expand access to medicines for people in need. As a whole, the report makes short-term and long-term recommendations towards introducing more systematic and sustainable approaches to meeting unmet needs in innovation and access.