Prevention: How Much Does Italy Spend Compared to the European Average?

In recent years, Italy’s public spending on prevention has been critical in terms of both quantity and distribution of resources compared to other European countries. Eurostat data show that the European Union allocated an average of 0.65% of GDP to prevention in 2021, with countries such as Austria, the Netherlands and Denmark exceeding 1% of GDP. Italy, by comparison, is below average, with around 0.4% of GDP invested in prevention.

This difference is also reflected in terms of per capita expenditure. While countries such as Austria and Denmark record figures of more than 500 euros per inhabitant allocated to prevention, Italy stops at around 192 euros per capita, a figure closer to those of countries that invest less, such as Malta and Slovakia.

 

The important gap between spending on prevention and spending on treatment and rehabilitation

The lack of attention to prevention contributes to the difficulties of the National Health Service (NHS), which has to deal with an increasing number of curative and rehabilitative interventions. The GIMBE Foundation’s report highlights how low spending on prevention limits the system’s ability to reduce the incidence of chronic diseases and keep the population healthy in the long term. Moreover, this figure contributes to the economic pressure on the Italian healthcare system, as it increases the need for more expensive and complex treatments. Interesting is the figure derived from FASI research, which shows that out of 130.3 billion allocated in 2023 to finance the ‘public good health’, 75% was allocated to treatment-rehabilitation services and drugs and only 4% to prevention (8.3 billion). This phenomenon is also found in the out-of-pocket health expenditure of households where cure-rehabilitation plus drugs account for 82%, while prevention only 0.2%.

"To date, prevention represents a marginal item in both public and private expenditure. The spending budget of Italian families is strongly unbalanced on current expenditure (home, food, transport, personal care, catering...) rather than on investment in health [....]." - Fabio Pengo, Fasi Vice President

European trends

The COVID-19 pandemic led some European countries to increase funds for prevention, especially for immunisation and screening programmes, pushing up preventive spending by more than 88% in Europe between 2020 and 2021. However, in Italy, funds for prevention, although temporarily reallocated during the pandemic crisis, have not had a significant structural increase. The GIMBE Report notes that, after COVID-19, Italy’s levels of preventive spending have returned to limited values, without a sustained expansion of prevention and health promotion services.

Recommendations

To reduce the gap with other European countries and increase the sustainability of the NHS – especially in the face of an ageing population and the consequent increase in chronic diseases – it is crucial for Italy to increase the share of public spending on prevention. Targeted investments in chronic disease prevention programmes and health education campaigns would help improve the population’s health and contain long-term health costs, in line with European recommendations.

Sources:

Gimbe Report, 2024
FASI, 2024
Eurostat, 2021