Changes in demographic and morbidity patterns, new medical technologies, inefficiencies in the system and the structure of the labor market represent a challenge for the fiscal sustainability of the health system in Colombia since they require an increase in public resources and permanent sources of financing. The authors estimate that an additional 1.91% of the Gross Domestic Product in public resources will be required in 2030 compared to 2022. They emphasize that efficiency improvements in the use of available resources and increased productivity would contribute to reduce the need for fiscal resources and improve the welfare of the population.