BREATHING IN A NEW ERA
A COMPARATIVE ANALYSIS OF LUNG CANCER POLICIES ACROSS EUROPE
Health System Financing
Comparability issues arise when looking to
understand potential associations between
cancer outcomes and health systems between
countries. Health spending varies according to
national wealth, government involvement in
health and social care, and variations in financing
methods. The health systems in Austria, Belgium,France, the Netherlands, Poland and Romania
are funded by insurance. In contrast, those of
Finland, Norway, Spain, Sweden and the UK are
tax based.^74 Evidence suggests that national health
systems have more control over expenditure, more
equitable distribution of resources and lower out
of pocket expenses compared with social insurance
systems. However, cancer survival appears to be
similar regardless of financing method.^74Lung cancer has been under-researched
Given the burden of the condition, it has been argued that lung cancer has historically been under-
researched when compared to other cancers.^75 Despite causing 20% of cancer mortality, lung cancer
receives only 5.6% of all cancer research funding.^76 Improvements in public engagement and advocacy
may help to address this anomaly.^77
Obtaining reliable, comparable research spend on lung cancer specifically—or indeed
cancer in general—is challenging. To gain an understanding of how research is prioritised across
included countries, we looked at the percentage of GDP used to fund R&D in general ( i.e. not just
pharmaceutical or clinical research). The rates varied widely in our 11 countries: Romania, Poland and
Spain invest the least into research; Sweden, Austria and Finland the most (Figure 10).Source: World Bank, 2019.Figure 10: R&D spending
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Sweden Austria Finland Belgium FranceNetherlandsNorway UK Spain Poland Romania