How to spend it?: Smart disinvestment choices in health

Past event

How to spend it?: Smart disinvestment choices in health


Friends of Europe is launching a reflection process on health (dis-)investment in Europe. A diverse group of stakeholders will be convened for roundtables to discuss the complementary issues of smarter investment for better health and disinvestment in health interventions that are ineffective, inefficient and outdated. These discussions will culminate in a publication summarising the highlights of each roundtable and commentary through opinion pieces from leading players in innovation for health.

This work is a follow-up on the results of a previous Friends of Europe Working Group on Health that generated recommendations for the 2014-2019 European Commission and European Parliament mandate. 21 recommendations on what the EU should start or stop doing, or do differently, were agreed on among the key health stakeholders that composed the group. A key focus of this work was to identify and highlight the need to stop doing things that are inefficient or ineffective. The proposed new series on health (dis-)investment follows directly from this recommendation.

This event is part of Friends of Europe’s Health and Wellbeing programme, which focuses on how the obstacles of vested interests and short-term political thinking can be overcome in the difficult transition to new healthcare models and systems – and how these new systems can be financed.

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How to spend it?: Smart disinvestment choices in health
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Life expectancy in the EU is more than eight years longer than the world average, partly due to universal access to high quality healthcare. However, healthcare systems across the OECD countries share similar challenges, such as an ageing population with increased need for care for chronic conditions, increasing costs and limited funds. But not all healthcare interventions are fit for purpose. About one third of all healthcare treatment is inefficient or ineffective according to some research evidence. One in 10 patients is harmed by the healthcare they receive, and about 15% of hospital costs go toward correcting preventable medical mistakes or hospital-acquired infections.

This is a significant waste of resources and doesn’t deliver better population health. Bureaucratic procedures and outdated or redundant medical practices don’t help. Yet, just few countries have created strategies to actively disinvest in what no longer works or provides value for money while this could potentially reduce poor health outcomes, save resources and streamline health delivery.

The methodology for Health Technology Assessment (HTA) has been well developed at EU and national levels. But there is little research on how to identify which health interventions are of minor or no health benefit. Advances in genomics, including gene therapies, and the overall focus on personalised medicine raise new questions about what constitutes a high or low value health intervention.

  • What would a strategy of health disinvestment look like?
  • Where to start reviewing health interventions?
  • How could big data generate insights on what works well or not?
  • Could this be part of the EU’s Health Systems Performance Assessment (HSPA)?

The event will bring together a select group of some 40 high-level stakeholders from across Europe, including EU and national policymakers, senior officials from international organisations, business representatives, NGO leaders, experts from the academic world.

It is the second of a series of two working group meetings. The series will culminate with a presentation of the outcomes at the European Health Forum in Gastein.


Tamsin Rose




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