As healthcare budgets in Europe receive a vigorous pruning, few areas look set to soar. One area where sales should rocket (albeit from a low base) is chronic disease management programmes.

Typically based on telehealth with nurse mentors coaching patients, these should double over the next couple of years, according to Chris Coloian, senior vice president at Health Dialog, the US chronic disease management consultancy owned by BUPA.

He reckons the European market could be worth 20-25% of the US market within two years.

Given that the US is growing at 10-15% a year, and is worth $2.5bn today, that suggests Europe could be worth $500m-$700m by 2011.

Certainly there is plenty of movement: Sophia, the French diabetes project, is just getting off the ground, the Finns will soon roll out their diabetes programme, Dehko, nationwide and plan follow-ons for other conditions and German and Dutch insurers are now financially incentivised to run such programmes.

In fact, I think Chris's rough forecasts could be low. At Healthcare Europa we are constantly stumbling on new projects in Switzerland, Austria and the Netherlands, although I am told the Dutch project is one of the few to treat chronic obstructive pulmonary disease (COPD) successfully.

How much of this will be run by existing national health resources and how much of the spend will be subcontracted is an interesting question.

Chris reckons the UK and France are likely to deploy existing resources. However, I think Germany, where there is very limited primary care, is outsourcing to providers like US provider Healthways and home-grown talent Anycare.