Studies & publications Health & Economy

The impact of ageing on health spending

The rapid ageing of the French population is profoundly reshaping the care requirements and sustainability of the health system. To measure the effects, Clariane and consultancy firm Asterès estimated the impact that ageing will necessarily have on health spending by 2050. Assuming that the supply and consumption structure remain unchanged, the study projects the development of costs related to this major demographic transition. As a result, it highlights the areas that are most exposed and invites us to begin rethinking health resource planning today.

The economic and structural challenges of ageing

According to the projections, ageing alone would lead to a 13% increase in health spending by 2050, an additional €41 billion. This will be accentuated by the increase in the population, particularly affecting hospitals, medical transport and hearing services. The study sheds light on the economic and structural challenges of ageing in a country where health spending already accounts for more than 12% of GDP.

325

billion: total health spending in France in 2023.

+13%

by 2050: the increase in health expenditure due to the mechanical effect of ageing, equivalent to a €41 billion increase.

+14%

increase in health spending by 2050 if population growth is taken into account, equivalent to an increase of €46 billion.

16%

projected increase in hospital spending by 2050.

32%

increase in expenditure on hearing aids, the greatest increase.

50%

The over-60s represent 50% of health expenditure while making up just 25% of the population.

This study reveals several major lessons

  • Accelerated ageing: the over-65s will make up 27% of the population in 2050, compared to 21% today.
  • A strong mechanical effect: based on the current structure, ageing alone would increase health expenditure by 13% by 2050.
  • An increase amplified by population growth: taking into account the changing population, the rise would reach 14%.
  • Hospital expenses on the front line: +6% from 2030, +13% in 2040 and +16% in 2050.
  • Fast growth in hearing care: +12% from 2030 and +32% in 2050, reflecting the increasing burden of age-related diseases.
  • Medical transport under strain: +7% in 2030 and +17% in 2050, reflecting increased mobility of elderly patients.
  • Spending focused on the elderly: the over-60s already represent about 50% of health expenditure, but just a quarter of the population.
  • A major macroeconomic challenge: with 12.3% of GDP devoted to health spending, France ranks second in Europe.
  • A need to look to the future: these developments call for a rethink of care distribution, preventative approaches and coordination of the patient journey.

Methodology

“Health spending” means Current health expenditure in the international sense (CHEi). In 2023, this totalled €325 billion. To calculate future health expenditure, Asterès’s projection is based on health expenditure per capita and by age being fixed over time, with only the age pyramid changing. Intermediate data and calculations The projection is based mainly on public data from the Research, Studies, Evaluation and Statistics Directorate (Drees) and the National Institute of Statistics and Economic Studies (INSEE), which has been reprocessed by Asterès. Drees publications are used for health expenditure by age. 

From the PMSI (information systems medicalisation programme) and DCIR (inter-regime consumption datamart), Drees has published detailed data for 2017 covering average expenditure per consumer and rate of care use by age group. Asterès used this data to estimate the average expenditure differences by age. These differences are presented using an index of 100 for 41-50-year-olds. Since the total does not cover all health expenses and the data is from 2017, only the differential has been retained for subsequent years, and this expenditure has been projected onto the total CHEi figure for 2023. For the INSEE data, Asterès retained the “middle” projection scenario based on 5-year age groups (0-4 years, 5-9 years, 10-14 years, etc.). As the brackets were shifted by one year from the data on average health expenditure by age, Asterès assumed that the difference was negligible. In other words, expenditure per person for 11-20-year-olds was considered usable to estimate expenditure per person for 10-19-year-olds.