European health systems are changing faster than at any point in the past decade. The debate has shifted. The question is no longer whether reform is needed. It is whether it is happening fast enough, and at sufficient scale.
That is the central message of the 2025 State of Health in the EU (SoHEU), published by the European Commission in partnership with the OECD and the European Observatory on Health Systems and Policies. Together, the 29 Country Health Profiles and the Synthesis Report offer a consolidated view of health trends, system pressures and reform pathways across all EU member states, as well as Iceland and Norway.
The reports do not rank countries. Instead, they identify shared challenges and emerging patterns. They show where policy action is accelerating and where gaps persist.
Uneven gains
Life expectancy across the EU continues to rise. It now stands at around 81.7 years. This reflects long-term improvements in survival and care, despite recent shocks.
Yet progress remains uneven. Gaps in life expectancy between countries still exceed eight years. These differences point to persistent inequalities in prevention, access and socioeconomic conditions. The reports warn that rising averages risk obscuring widening disparities if reforms fail to reach lagging regions and vulnerable groups.
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Longer lives also bring more complex care needs. More than one-third of adults in the EU report a long-standing illness. Among people aged over 65, the figure rises to nearly 60 per cent, according to the Country Health Profiles. Chronic disease management has therefore become the defining task for health systems.
Preventable diseases
The Synthesis Report highlights the scale of avoidable harm. In 2022, more than 725,000 deaths across the EU could have been prevented through effective public health action. Cardiovascular disease, cancer, diabetes and chronic respiratory conditions account for most of these deaths.
The report also links health outcomes to economic performance. Non-communicable diseases cost the EU an estimated 2.4 million potential productive life years in a single year. They directly affect labour participation and productivity. Preventing NCD-related mortality could reduce the projected workforce decline by 12 per cent between 2022 and 2040, partly offsetting demographic ageing.
In 2022, more than 725,000 deaths across the EU could have been prevented through effective public health action. — Synthesis Report
Despite this, prevention remains underfunded. It accounts for only around four per cent of total health spending on average. The Country Health Profiles also show that behavioural risks persist. Smoking, obesity and physical inactivity remain widespread, with particularly worrying trends among younger people.
The pressure point
Across countries, the reports converge on one conclusion. Primary care is under strain just as demand peaks. Only one in five doctors in the EU works as a general practitioner. At the same time, chronic conditions and multimorbidity continue to rise. The Synthesis Report identifies primary care reform as one of the most active policy areas, with member states testing workforce incentives, task-shifting and new community-based care models.
EU funding plays a central role. The Country Health Profiles show how the Recovery and Resilience Facility and Cohesion Funds support investment in primary care infrastructure, training and access, especially in underserved and rural areas. Workforce shortages and uneven implementation, however, continue to limit impact.
The SoHEU cycle confirms that Europe has made strong progress on digital health infrastructure. Investment in health-related information and communication technologies has risen by around 30% compared with the pre-pandemic period. All member states now provide some form of electronic health record access.
Digital health has scaled
Use tells a different story. The Synthesis Report draws a clear distinction between technical availability and real-world adoption. Engagement with electronic health records remains uneven across countries and population groups, particularly among older people and those with lower levels of education.
Investment in health-related information and communication technologies has risen by around 30 per cent compared with the pre-pandemic period.
The reports frame the European Health Data Space as a key lever for the next phase of reform. The focus is shifting from rollout to interoperability, governance and trust. Together with the EU’s Artificial Intelligence Act, digital health policy is moving from experimentation to system integration.
Pharmaceuticals feature prominently across all Country Health Profiles. Their weight in health budgets and patient outcomes continues to grow. In 2023, pharmacy medicines accounted for around 60 per cent of pharmaceutical expenditure and 13 per cent of total health spending in the EU.
Access and innovation
The Synthesis Report documents a wave of national reforms between 2020 and 2025. These aim to improve affordability, access and financial protection while containing costs. Many now align with EU-level initiatives, including the reform of pharmaceutical legislation, the Health Technology Assessment regulation, and the Critical Medicines Act. Access to medicines increasingly links to supply security and industrial resilience.
Taken together, the State of Health in the EU 2025 reframes health policy as a strategic investment agenda. Prevention, primary care, digitalisation and pharmaceutical innovation now link directly to economic resilience, labour markets and competitiveness.
The Reports are a clear wake-up call: non-communicable diseases, with heart disease as the biggest contributor, remain the leading cause of preventable illness and death. — Olivér Várhelyi, EU Health Commissioner
European Health Commissioner Olivér Várhelyi captured this shift at the report’s launch. “The Reports are a clear wake-up call: non-communicable diseases, with heart disease as the biggest contributor, remain the leading cause of preventable illness and death,” he said. “Strong and innovative health systems are essential to the EU’s economic growth and global competitiveness.” The State of Health in the EU cycle does not end with diagnosis. As attention turns to 2026, the reports make one message clear. Momentum now needs to translate into delivery.
From diagnosis to delivery
Prevention funding will need to scale up, particularly for cardiovascular disease, obesity and youth health, as the EU prepares to roll out its cardiovascular health plan. Primary care reform must move beyond pilots. EU funding will need to support lasting workforce capacity through sustained training, retention and task-shifting.
Digital health policy will face a similar test. Success will depend less on infrastructure and more on adoption. Progress will need to show in electronic health record use, digital literacy and cross-border data exchange under the European Health Data Space. Pharmaceutical reform will also move into a decisive phase as EU legislation and the Critical Medicines Act shift from negotiation to implementation.
As the next Country Health Profiles are prepared, the focus will increasingly fall on outcomes rather than intentions. The evidence base is now well established. The real test is whether reform can keep pace with Europe’s health needs and demographic realities.
