Predictions for 2019

Bristol-Myers Squibb’s $90bn purchase of Celgene signals the start of a disruptive year for health. With borrowing costs low and equity values falling, the deal will intensify pressure for further consolidation in the pharmaceuticals sector. Takeda's £46bn takeover of Shire currently being finalised signals that Japanese companies are active internationally (albeit that the business is run by a Frenchman).

The industry is set to face fresh pressure on medicine pricing in the US, with both President Donald Trump and the newly Democrat-controlled House probing spiralling healthcare costs and gaps in coverage. Lower cost biosimilars and other generics will also weigh on companies facing expiry of their product patents.

Technology will continue to disrupt healthcare, including in drug discovery, diagnosis, monitoring and medicine purchases. So will the related debate over the trade-offs between the benefits of wider access to computing power and the risks it raises for privacy and commercial influence.

As populist leaders threaten trade wars and turn inwards, there are risks of supply chain disruption: Brexit is forcing the healthcare sector to stockpile medicines in the UK, and in India the government is requiring 75 per cent “local content” in medicines produced for the domestic market.

Similar political sentiments will add to the calls for governments in lower and middle income countries to contribute more of their own resources to tackle diseases. At the same time, there will be fresh calls to donors to support the Global Fund to Fight Aids, TB and Malaria, the Global Financing Facility, Gavi, the vaccine fund, and efforts to continue the long-running international effort to eradicate polio.

With rising demand, slowing economic growth and the diversions of Brexit, the UK’s National Health Service will be among a number of health systems coming under funding pressure around the world. Yet elsewhere there is continued political momentum towards “universal health coverage”, including initiatives in Kenya, South Africa and India.

In public health, expect growing concern over the Ebola outbreak spreading in eastern Democratic Republic of Congo, the continued spread of anti-microbial resistance globally and the likely emergence of a dangerous new pathogen from Asia. 

It will be another tough year for prevention, the eternal orphan struggling to get its demands for support heard against the immediate pressures to improve treatment. Continuing misinformation spread online by anti-vaccine groups will contribute to further resurgence in deaths from diseases such as measles. And while “big food” may be the new “big tobacco”, governments remain reluctant to curb marketing of unhealthy food and drink.

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Readers' views

A selection of your predictions.

@MartenRobert via Twitter:

Amelia Earnest, Global Health Strategies:

The concurrent, competing replenishments of major funds — including the Global Financing Facility, Global Fund, Gavi and Global Polio Eradication Initiative — will determine whether the world continues to invest in multilateral systems or retreats back into an older, less efficient bilateral model for distributing aid. Donors’ response will impact millions of children, determine if the world bridges the final gap to eradicating polio and shape overall development for years to come.

Sylvana Sinha, founder and CEO of Praava Health in Bangladesh:

In 2018, we began to see experimentation in advanced economies with value-based healthcare models that price care to incentivise good health outcomes . . . In 2019, we expect to see experiments spill out to the “Global South” and emerging markets seeking to provide value-based care at scale, which is a leapfrog development opportunity.

Laure-Anais Zultak, Global Health 50/50:

Women make up 75% of the global healthcare workforce and 80% of US global health students, they occupy less than 25% of the most influential global health leadership positions . . .In the context of the wider #metoo movement rolling on, there is no doubt that the gender equality momentum in global health will continue to accelerate in 2019 and will open up the conversations about other lines of inequalities.

Most clicked in 2018

Disease attributable to alcohol and drug use (The Lancet)

Could you pass the cognitive test Donald Trump took? (Mirror)

Changing trends in mortality — an international comparison (ONS)

WHO Mental Health Atlas (WHO)

Euro Health Consumer Index (Health Powerhouse)

Breastfeeding: it's bad for business! (Guardian)

Drugmakers funnel millions to lawmakers (Kaiser Health News)

The economies with the most (and least) efficient healthcare (Bloomberg)

The 50 most influential people in US healthcare (Time)

Is there a doctor on the plane? (Jama)

2019 calendar

Jan 16 — FT Health at Work magazine

Feb 4 — World Cancer Day

Mar 21 — FT Digital Surgery Conference, San Francisco

Mar 24 — World TB Day

Apr 7 — World Health Day

Apr 24 — World Immunisation Week

Apr 25 — World Malaria Day

May 13 — Mental Health Awareness Week (Theme: body image)

May 14 — FT US Pharma and Bioscience Summit, New York

May 21 - World Health Assembly begins

May 31 — World No Tobacco Day

Jun 14 — World Blood Donor Day

Jun 18 — FT Digital Health Summit, Berlin

Jul 28 — World Hepatitis Day

Sep 10 — World Suicide Prevention Day

Sep 26 — FT Pharma Pricing and Value Summit, New York

Oct 10 — World Mental Health Day

Nov 11-12- FT Global Pharma and Biotech Conference, London

Nov 12 — World Antibiotic Awareness Week

Nov 14 — World Diabetes Day

Dec 1 — World Aids Day

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