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Attention doctorportal newsletter subscribers,

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As of January 2019, we will no longer be sending out the doctorportal email newsletter. The final issue of this newsletter will be distributed on 13 December 2018. Articles from this issue will be available to view online until 31 December 2018.

[Correspondence] Health economics – Authors’ reply

As Theodore Papaioannou and colleagues point out, projecting long-term health spending is challenging.1 Our Article2 and extensions of this research3 made health spending projections for 184 countries and extends through 2040. Many factors—environmental, epidemiological, demographic, cultural, political, economic, and scientific—influenced the creation and evolution of complex health systems, and have coalesced to determine current health spending levels. These same factors will undoubtedly also influence health spending in the future, although how these factors will interact and determine precise spending is difficult to predict.

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