Megatrends in Global Health Care

Megatrends in Global Health Care

by Karen Dillon and Steve Prokesch

Harvard Business Review


Megatrend 1: Innovation and demand soar in emerging economies

Spending on health care in countries such as China and India will continue to rise in line with their economic growth, and they will become big markets for health care companies. Serving them will require innovations in technologies and delivery and business models — some of which will be adopted by developed countries. Demand for vaccines and treatments for traditionally “Western” diseases will soar in these countries.

Megatrend 2: Personalized medicine and technological advances

With the cost of decoding an individual’s genome expected to fall in the next two to three years to $1000 from its current price range of $10,000 to $25,000, the market for genome decoding in developed countries will explode. This will lead to a greater understanding of disease and the development of new therapies but will raise complex privacy and cost-benefit issues.

Megatrend 3: Aging populations overwhelm the system

Aging populations will lead to increases in the number of people suffering from chronic, expensive-to-treat diseases and disabilities, straining health-care systems. Polarizing issues will result: will there be shortages of health care workers to cope with demand? What’s the cost-benefit analysis of keeping aging people with deteriorating quality of life alive? And who gets to decide?

Megatrend 4: Rising costs

You think costs are bad now… Aging populations and technological advances will cause health care costs throughout the world to continue to rise and will have a widespread impact on health care spending, design of national systems, and delivery.

Megatrend 5: Global pandemics

The world has become more sophisticated at coping with potential pandemics, but urban sprawl, population growth, global travel, and rudimentary delivery systems in poor countries ensure that global pandemics will remain a serious threat. HIV/AIDS continues to be out of control in Africa, devastating populations and economies.

Megatrend 6: Environmental challenges

Causes of illness are all around us. The effects of poor water and air quality, pathogens in food supply, and urban sprawl and congestion will cause dramatic health care challenges for decades to come.

Megatrend 7: Evidence-based medicine

Data on outcomes will increasingly be used to develop standard protocols for treating many diseases, resulting in a movement away from the long-dominant “what you and your doctor decide is best” judgment-based medicine. Could this lead to health care Czars who will establish protocols and penalize physicians who deviate from them?

Megatrend 8: Non-MDs providing care

Shortages in primary care physicians, rising costs, and standardization of protocols and technology will bring about dramatic changes in who treats patients — with more emphasis on nurse practitioners, physician’s assistants, and others who aren’t MDs. Megatrend 9: Payers’ influence over treatment decisions

Rising costs around the world will cause the power to decide how to treat patients to shift from health-care professionals to payers, who will assess the added “quality-adjusted life years” that a potential treatment offers. Some major pharmaceutical companies are already responding by changing their R&D strategies.

Megatrend 10: The growing role of philanthropy

Foundations and other NGOs will play a leading role in funding research to develop drugs and delivery systems for preventing and treating diseases that mainly plague poor countries (e.g. malaria and TB).

Megatrend 11: Prevention is the next big business opportunity

More dollars will be spent on vaccines and other means of preventing or reducing the incidence and severity of serious diseases (e.g. cancers) and chronic conditions (e.g. obesity-related illnesses such as diabetes). It remains to be seen whether consumers will cooperate. Smoking is only slowly diminishing and a disappointing number of people are getting colonoscopies.

Megatrend 12: Medical tourism

The allure of good care at much lower prices will cause increasing numbers of people to go abroad for cheaper treatment. The Deloitte Center for Health Solutions predicts that the number of Americans traveling abroad for treatment will soar to more than 1.6 million in 2012. Will cost pressures cause payers around the world to be more amenable to sending patients in their countries abroad for cheaper treatment?

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