According to a research article published in the international journal BMJ Global Health, current strategies for treating patients with several chronic diseases are putting an unnecessary financial burden on countries' health systems and individuals.

The current clinical practice of tackling each disease in isolation may lead to the prescription of unnecessary medicines, resulting in patient expenses that are disproportionate to the number of conditions they have. Researchers analysed the raw data from 14 global studies that measured the out-of-pocket expenditure — costs not covered by insurance — of patients with multiple chronic diseases.

These patients, who have multimorbidity, suffer from high out-of-pocket costs and may stop taking their medicines as a result. The elderly and low-income groups are, particularly at risk. Patients may have financial support from insurance benefits to visit their general practitioners or go for medical check-ups, but the weakest link is the lack of financial support to pay for any medications prescribed.

The research also found a common coping mechanism by some patients with high spending on medicines is non-adherence, whereby patients stop taking their medicines by failing to refill their prescriptions, which is a substantial healthcare issue. As the number of chronic diseases increased from none to one, the annual out-of-pocket expenditure grew by an average of 2.7 times.

An increase from one to two conditions and from two to three increased average costs by 5.2 and 10.1 times, respectively. The increasing costs meant that patients could afford fewer other medical services. The nature of chronic diseases is that they require long-term management and usually cannot be cured, which exacerbates the high cost to patients for medicines over a long period of time.

It is imperative for healthcare policymakers to start recognising this problem, in order to design better policies that offer financial protection on medicines for chronic diseases. Despite multimorbidity being the norm rather than the exception for the older population, the current clinical practice remains focused on single chronic disease in isolation.

Multimorbidity is a rapidly growing major and unaddressed challenge for health systems with ageing populations. Yet, worldwide, resources and services in health systems are not aligned to meeting the needs of elderly individuals with multimorbidity. As a result, individuals with multimorbidity experience inadequate health services, and high levels of out-of-pocket expenditures that are impoverishing and detrimental to their economic and social well-being.

The burden of co-occurring chronic diseases is a growing global health challenge. The study brings the real-life impact on the lives of people living with multiple chronic conditions to the fore and accentuates the need to scale up solutions in integrated care to accelerate action to achieve Universal Health Coverage.

The research findings suggest that we need to think more carefully about how to improve the cost-effectiveness of treating patients with multiple chronic diseases. This study provides further impetus for leaders to put people first in their response to reduce the burden of having multiple chronic conditions, by prioritising equitable access to treatment and care for all.