The level of health spending is likely to grow, as a consequence of the aging of the population, the epidemiological transition towards non-communicable diseases, the implementation of universal health coverage and the adoption of new technologies. All of these factors can result in an increase in the demand for health services. But the current deterioration in fiscal balances and poor growth prospects predict budget constraints in the future. Therefore, countries should focus their attention on better options for using available resources, rather than blindly cutting budgets and compromising public services. Today more than ever, improving the efficiency of health spending, that is, achieving the maximum benefits with the available resources, must be a priority.