[Less need for prevention through better care? Towards an effective deployment of preventive and curative care]

Scientists and politicians repeatedly call for more investment in prevention. Besides improving public health, this would reduce health care spending. This article discusses two mechanisms that are relevant to the debate regarding the efficiency of prevention. The first mechanism concerns the additional demand for health care as a result of increased life expectancy. The second mechanism concerns the impact that improvements in curative care have on the consequences of prevention. Both mechanisms show that prevention and curative care cannot be considered separately. Consequently, decisions on investments in preventive and curative care should ideally be based on the same decision-making framework. An effective deployment of prevention and care will benefit from economic evaluations that give as full a picture as possible of both the costs and benefits of new interventions.