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Assessing the cost-effectiveness of prevention

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Abstract

In an era of limited resources, cost-effectiveness analysis and cost-benefit analysis (CEA/CBA) can be significant policy-making aids. Because the often stated belief that prevention is cost-effective has not been systematically examined, we surveyed about 250 CEA/CBA articles concerning prevention. We found that few authors have followed generally accepted methodological standards, which raised questions concerning the validity of their findings and conclusions. In addition, prevention itself is a problem in CEA/CBA because of such factors as the long intervals between interventions and outcomes, problems which have rarely been considered in the CEA/CBA prevention literature. At the same time, a number of high quality studies concerning prevention indicates that United States policy makers have not aggressively pursued significant opportunities to improve health through prevention, for example by immunizing the elderly and by screening for and treating hypertension. We recommend that analysts follow general methodological principles in CEA/CBA prevention studies to assure both valid and credible results.

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Authors
  1. H. David Banta M.D., M.P.H.
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  2. Bryan R. Luce Ph.D.
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Additional information

Dr. Banta is Assistant Director of the Office of Technology Assessment, Congress of the United States, Washington, D.C. 20510. Dr. Luce is Director of the Office of Research and Demonstrations, Health Care Financing Administration, Washington, D.C. 20201. The authors are grateful to Clyde Behney, Joyce Lashof, and Patricia Bauman for helpful comments on an earlier version of this manuscript paper. The paper was presented at the meeting of the Association of Teachers of Preventive Medicine in Los Angeles, CA on November 1, 1981.

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Banta, H.D., Luce, B.R. Assessing the cost-effectiveness of prevention. J Community Health 9, 145–165 (1983). https://doi.org/10.1007/BF01349877

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