In 2004, the US National Center for Health Statistics reported that 80% of the elderly population (adults aged 65 years and older) took at least one prescription drug in the prior month. Its survey revealed that around half of the individuals in the same age group reported taking three or more prescription drugs and that this statistic represented an increase of nearly 50% over the prior 5–10 years (2). The issue of polypharmacy is also of particular concern in the elderly, who, compared with younger individuals, tend to have more disease conditions for which medicines are required (3). While pan-European figures are hard to come by, these insights into trends in healthcare usage by the elderly studied elsewhere in the world should be considered relevant for the future of healthcare in Europe.
Optimism and harsh realitiesThe European Commission's (EC) official position is to actively support Member States in their efforts to promote healthy ageing through dedicated initiatives to improve the health of older people. An ageing population in good health will also mean less strain on health systems and fewer people retiring from work due to ill health. At present, the European Innovation Partnership on Active and Healthy Ageing aims to ensure that the average European citizen has two more active and healthy years to live by 2020 (4). The EC have termed ageing as an opportunity for the region rather than a hindrance. The Partnerships Steering Group was set up in May 2011, and is made up of more than 30 stakeholders representing the health and ageing area, including Member States and regions, organisations representing older patients, nurses, carers and doctors, hospital representatives, academics, industry and venture capitalists organisations. It has already announced that in 2012, it will launch calls for involvement of stakeholders beyond those that participated in the Steering Group to implement together the priorities and actions identified in a Strategic Implementation Plan that it adopted at a meeting in November 2011 (4).
While those behind the initiative push the project forward, their optimism sits in contrast to the current realities because funding and resourcing healthcare systems through societies with smaller workforces is becoming extremely difficult. Most governments have no choice but to make cutbacks in the current, uncertain economic environment, which affects the ability to deliver effective healthcare services for the growing elderly population. For example, the EU recently and dramatically revised its growth forecast for the Eurozone in 2012, from 1.8% to a mere 0.5% (5). Such financial predictions will do little to convince nervous politicians to provide additional investment for initiatives to boost healthcare systems that are already underfunded.
The ominous situation in Greece illustrates the difficulties that can arise in the current economic climate. As a result of the economic meltdown, doctors' wages in the public system have been cut in line with those of other government workers, and hospitals are at risk of being merged and face regular shortages of materials. Even patients who should be entitled to reduced or free medication often cannot find pharmacists to provide them and are instead asked to pay the cost up front and then seek reimbursement.