How Cost-Effective Are Public Health Interventions?

While public health interventions such as smoking cessation programs, physical activity programs and workplace wellness initiatives are known to be effective, have you ever wondered whether they are cost-effective? Sure, they may work, but is our healthcare dollars better spent elsewhere? Are they good value for money?

A new study attempts to look at this question, focusing on England’s National Health Service (NHS). Researchers from the University of London and the National Institute for Health and Clinical Excellence (NICE) looked at a wide variety of public health interventions to determine whether they are cost-effective. In their analyses, they used NICE’s thresholds as follows: interventions costing less than £20 000 (roughly $31,300 USD) per quality-adjusted life year (QALY) were considered to be cost-effective, interventions costing between £20 000 and £30 000 (roughly between $31,300 and $47,000 USD) per QALY may be considered cost-effective if certain conditions are satisfied, and finally interventions costing more than £30 000 (roughly $47,000 USD) per QALY were not considered to be cost-effective.

Overall, the researchers found that the vast majority of public health interventions to be cost-effective: 85% were cost-effective at a threshold of £20 000 per QALY and 89% at the higher threshold of £30 000 per QALY. Based on these findings, the authors made the following statement:

This analysis showed that the public health interventions considered by NICE are generally highly cost-effective according to the NICE threshold. As such they represent good value for money. Given that the cost per QALY for most interventions is extremely low, it seems likely that as a nation we are not investing sufficiently in public health interventions.

It makes you wonder why these interventions are not deployed more frequently here in the United States.

For more information on this study, go to: http://www.ncbi.nlm.nih.gov/pubmed/21933796