Assessing the cost-effectiveness of prevention

Area of Science:

• Health Economics
• Public Health Policy
• Preventive Medicine

Background:

• Cost-effectiveness analysis (CEA) and cost-benefit analysis (CBA) are crucial for policy decisions with limited resources.
• The cost-effectiveness of preventive healthcare strategies is often assumed but not systematically evaluated.
• Existing literature on CEA/CBA for prevention faces methodological challenges.

Purpose of the Study:

• To systematically examine the quality of cost-effectiveness and cost-benefit analyses concerning preventive interventions.
• To identify methodological limitations in the current body of literature on CEA/CBA for prevention.
• To assess the implications of these limitations for public health policy and decision-making.

Main Methods:

• A comprehensive survey of approximately 250 articles employing cost-effectiveness analysis (CEA) and cost-benefit analysis (CBA) focused on prevention.
• Evaluation of surveyed articles against generally accepted methodological standards for economic evaluations.
• Analysis of specific challenges in applying CEA/CBA to preventive interventions, such as long time horizons.

Main Results:

• A significant proportion of surveyed CEA/CBA articles on prevention did not adhere to established methodological standards.
• Methodological weaknesses raise concerns about the validity and reliability of findings in prevention-focused economic evaluations.
• Despite evidence of effective preventive opportunities (e.g., immunizations, hypertension screening), policy adoption remains limited.

Conclusions:

• There is a critical need for improved methodological rigor in cost-effectiveness and cost-benefit analyses of preventive health strategies.
• Adherence to methodological principles is essential for generating valid and credible evidence to inform health policy.
• Policy-makers should more actively pursue proven preventive interventions to improve population health outcomes.