DOES PREVENTION PREVENT SAVINGS?

Volume 29, Issue 510 March 3, 2008

Matthew Gever

Many health-care reform proposals would increase spending on and access to preventive care. The belief is that prevention will reduce the spiraling costs of health care by preventing chronic conditions from developing or becoming worse. “Sweeping statements about the cost-saving potential of prevention, however, are overreaching,” says new research on the costs of prevention.

In some cases, preventive measures can actually add costs to health care. For example, the costs of screening for a disease that affects only a tiny fraction of the population would far outweigh any savings from avoided treatments. The researchers also pointed out that some treatment measures, while expensive, can still be a more efficient use of health-care dollars than screening measures. Overall, the idea of cost-savings through preventative care has to be analyzed on a disease-specific basis. The authors hope this research will lead to “careful analysis of the costs and benefits of specific interventions, rather than broad generalizations.”

The graph below was drawn from 599 cost-effectiveness studies of preventive measures. The graph shows that when it comes to efficient investment, prevention and treatment measures are roughly equal.

No Savings in Prevention

Distribution of Cost-Effectiveness Ratios for Preventive Measures and Treatments for Existing Conditions. Data are from the Tufts–New England Medical Center Cost-Effectiveness Registry. QALY denotes quality-adjusted life-year.

Source: Joshua T. Cohen, Ph.D., Peter J. Neumann, Sc.D., and Milton C. Weinstein, Ph.D. Does Preventive Care Save Money? Health Economics and the Presidential Candidates, New England Journal of Medicine, 2008 Feb 14;358(7):661-3.