Acting Early on Non-Communicable Diseases 2026

2.4 Tertiary prevention: Treatment and disease management Successful models demonstrate what structured chronic disease management can achieve. Germany’s Disease Management Programmes (DMPs), introduced in 2002 and now covering millions of patients with chronic conditions, have documented significant improvements – for example, better HbA1c control for diabetes and reduced hospitalizations for cardiovascular disease.48,49 However, significant implementation challenges have been raised, including administrative burden, limited flexibility for individualizing treatment and variable regional uptake.50 Italy’s DM77 reform, implemented in 2022, establishes community health centres as integrated care hubs with multidisciplinary teams, representing substantial reorganization of primary care infrastructure, though the reform remains in the early implementation stages.Current landscape Hospital admissions for congestive heart failure, diabetes and COPD (adults per 100,000)51 FIGURE 3 206 167 459 160 363 287* 161 262 204 575 292 391 276 188 Congestive heart failure OECD Spain Poland Japan Italy Germany France Canada 102 57 121 11** 31 172 156* 94 153 60 248 17 54 244 203 102 Diabetes 23 129 132 83 193 159* 132 245 260 281 109 257 133 270 COPD 2011 2021 (or latest available) Notes: * = 2019 data; ** = 2020 data. Source: Adapted from: Organisation for Economic Co-operation and Development (OECD). (2023). Health at a glance 2023: OECD indicators. OECD Publishing, Paris Acting Early on Non-Communicable Diseases: A Framework for Health System Transformation 13