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 health improvement and chronic disease management company owned by BUPA. He reckons the European market could reach 20-25% of the US market within several years. Given that the US is growing at 10-15% a year and is worth $2.5bn that suggests Europe could be worth $500m by 2012.

Certainly there is plenty of movement with Sophia, the French diabetes project, 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. We are stumbling on new projects in Switzerland, Austria and the Netherlands. I am told the Dutch project is one of the few to treat COPD successfully.

How much 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.