Nursing Online – October 2010

Rob Carter, Professor of Health Economics, Deakin University
Rob Carter, Professor of Health Economics, Deakin University

Assessing the cost effectiveness of prevention. A major report on preventing illness in Australia has applied an economic cost-benefit analysis to identify which prevention measures are worthwhile and which aren’t providing value for money. The Assessing Cost Effectiveness project is a unique study involving 130 health experts who assessed 123 illness prevention measures.

The Assessing Cost-Effectiveness in Prevention report was launched on 8 September 2010

The Assessing Cost-Effectiveness in Prevention (ACE Prevention) is a large, five-year study that was funded by the National Health and Medical Research Council (NHMRC) and jointly led by Professor Theo Vos of the Centre for Burden of Disease and Cost-Effectiveness at the University of Queensland and Professor Rob Carter of the Deakin Health Economics Unit at Deakin University.

The overall aim of this project was to provide a comprehensive analysis of the comparative cost-effectiveness of preventive intervention options addressing the non-communicable disease burden in Australia, with a specific focus on Indigenous Australians.

ACE Prevention is the most comprehensive evaluation of health prevention measures ever conducted worldwide, involving input from 130 top health experts. The research team assessed 123 illness prevention measures to identify those that will prevent the most illness and premature deaths and those that are best value for money. For comparison purposes, 27 treatment interventions were included.

Report calls for value for money on preventative health
PM with Mark Colvin, ABC News, 8 September 2010

A major report has come up with a list of measures it says could prevent a million premature deaths. The aim was to work out what spending was worthwhile and what wasn’t. Among the measures deemed worthwhile were a junk food tax, lap-band surgery for the obese, and screening Indigenous Australians for diabetes and chronic kidney disease by the age of 25. The measures the report says should be dropped include some screening programs for prostate cancer, and illicit drug education in high schools. Health experts have welcomed the report but aren’t sure whether many of the programs will win the support of the minority Federal Government.

ACE Prevention pamphlets

Each pamphlet gives a brief overview of one of the topics in ACE Prevention. Below are some examples of topic areas.

Cost-Effectiveness of Skin, Cervical and Prostate Cancer Prevention and Breast Cancer Treatment.
Main messages from this topic are that the current cervical cancer screening program would become more efficient if the starting age is raised to 25; or the screening interval is extended to three years; or a more accurate screening test is used. Also that HPV vaccination of 12-year-old girls in Australia is cost-effective if accompanied by a screening program with a starting age of 25 and/or a three-year, instead of two-year interval.

Cost-Effectiveness of Preventive Interventions for Adult Depression
Key messages from this topic are that screening in general practice for early signs of depression followed by brief interventions is cost-effective and could avert up to 20% of the burden of depression.

Cost-Effectiveness of Alcohol Interventions
Intervention to prevent alcohol-related disease and injury is highly cost-effective: a package of seven preventive interventions could achieve a 31% reduction in the harmful and hazardous health effects of alcohol. Although the current practice of random breath testing in Australia is cost-effective, if the $71 million that is currently spent on random breath testing could be invested in more cost-effective interventions, over 10 times the amount of health gain could be achieved.