Forecasting total and cause-specific health expenditures for 116 health conditions in Norway, 2022-2050.

Background: This study forecasts total and cause-specific health expenditures in Norway to 2050 and quantifies the contribution of four key drivers-total population growth, population aging, changes in disease prevalence, and cost per case-on future health care spending.

Methods: We forecast spending for 116 health conditions in Norway from 2022 to 2050, using historical and forecasted data of population growth, disease prevalence, gross domestic product (GDP), health spending, and residual factors. Our analysis included a reference scenario that forecasted disease-specific health spending; two alternative scenarios examining the effects of alternative unit cost developments; and a scenario examining the consequences of improved behavioral and metabolic risk factors.

Results: Health spending increased from 10.6% (95% uncertainty interval, 10.2-11.1) of GDP in 2022 to 14.3% (13.0-15.7) in 2050 in the reference scenario. Among the top aggregate causes of Norwegian health spending in 2022, the spending for neurological disorders rose the most, from 1.7% (1.6-1.8) to 2.7% (2.3-3.1) of GDP, surpassing mental and substance use disorders which rose from 2.2% (2.1-2.3) to 2.4% (2.2-2.6) of GDP. Of the 116 single conditions analyzed, dementias accounted for the highest spending in 2022. This expenditure was forecasted to increase considerably from 1.1% (1.09-1.2) to 1.9% (1.6-2.2) of GDP by 2050, largely due to population aging. Spending on other old-age-related conditions like falls, stroke, and diabetes, was also forecasted to increase. Increased population, aging, and spending per case contributed to increased future spending. Reduced behavioral and metabolic risks were forecasted to increase the number of elderly persons and reduce age-specific disease prevalence but had little impact on forecasted health spending.

Conclusions: Health spending growth was forecasted regardless of the scenario, and Norway needs to plan for this. However, policymakers can curb total spending growth, while maintaining health care quality and output, by ensuring more efficient allocation and effective use of resources. While the overall impact of behavioral and metabolic risk reductions on total healthcare spending was modest, reducing risk factors is needed if countries aim to achieve a healthier, longer-living population.