OBJECTIVES : Identify hurdles to achieving healthcare sustainability in Latin America (LA), review approaches taken by policy makers to control healthcare budgets and pharmaceutical spending and propose actionable solutions to attain sustainability that mutually benefit healthcare systems and industry.

METHODS : Global benchmarks for healthcare sustainability, LA-specific hurdles challenging achievement of those targets and solutions to achieve sustainability successfully implemented in other regions were identified after reviewing 46 articles published by regional and international organizations (e.g., UN, WHO / PAHO, WBG, IDB, OECD, IFPMA, PhRMA, FIFARMA, etc.). Identified global solutions were prioritized based on the feasibility to implement, economic impact and time to impact.

RESULTS : Despite significant improvements made to achieve universal health coverage (UHC), LA’s four largest markets based on 2019 GDP - Argentina, Brazil, Colombia, and Mexico - remain below PAHO, WHO, and OECD benchmarks for healthcare sustainability. The pressure to expand coverage given UHC goals, aging population, and increasing prevalence of non-communicable diseases with an unfinished infectious disease agenda, combined with constrained budgets and inadequate use of resources have left LA healthcare systems unable to provide services required to meet population needs.

The current approach to healthcare sustainability focuses on cost-containment measures to control pharmaceutical spending, rather than addressing healthcare system inefficiencies holistically. Instead, policy makers and the pharmaceutical industry should collaborate to implement mutually beneficial short-term (tax exemption for pharmaceutical products, International Non-proprietary Name prescribing, and control of pharmacy and wholesaler margins), mid-term (managed entry agreements, value-based procurement, and sin-taxes on tobacco, sugar, alcohol, etc.) and long-term (value-based healthcare, social / health impact bonds) solutions to ensure long-lasting sustainability in LA.

CONCLUSIONS : Across LA the demand for health services has outpaced supply. Policy makers have responded by implementing measures that control pharmaceutical spending. Instead, relevant stakeholders should explore alternative approaches that address healthcare inefficiencies holistically.