EFPIA: Strengthening health systems through smart spending

Faced with an unprecedented health security crisis on top of the challenges of an ageing population and increasing burden of chronic diseases, our health systems need to both strengthen their resilience to future shocks and meet increased demand for healthcare, while staying sustainable over time. Whilst we need to keep investing in our health systems, in particular in some countries and regions in Europe where health expenditure is below the EU average, there are also opportunities to make healthcare spending more efficient. Smart healthcare spending will allow us to improve health outcomes while not increasing overall costs, or even create savings in the long-term that can be reinvested for better health. This is different from the short-term budget cuts that took place after the economic and financial crisis in 2008-2009, which many times led to worse health both at population and patient level in several European countries.
In order to inform a discussion on how smart spending can improve health systems’ resilience, responsiveness and readiness, EFPIA has developed a number of policy recommendations for national and European policy-makers. A number of case studies show how smart spending and health system planning can improve long-term outcomes while keeping the systems sustainable and flexible in order to respond to future challenges.


  • Measure outcomes and publish data
  • Improve care coordination, including through integrated health data and digital health
  • Promote efficiency through smart pharmaceutical spending
  • Strengthen prevention, early detection and intervention, including health literacy
  • Move to payment models that reward outcomes over volumes
  • Integrate budgets across the care cycle
  • Share best practices
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