Health prevention programs and interventions have the potential to generate substantial societal benefit. These benefits are too often ignored in the policy debate, where the focus tends to be on healthcare costs. A motion passed in the Dutch Parliament, as well as several commissions and organizations like The Social and Economic Council, have urged for better consideration of benefits and costs of prevention, through the development of adequate models and instruments that introduce these into the policy making process on a regular basis. At the same time, calculating the societal value of prevention measures is challenging: many prevention measures cannot be evaluated using randomized trials and the benefits of prevention often only materialize in the long run and outside of the health care sector.
On October 3, Francisca Vargas Lopes and Bram Wouterse, both affiliated with Smarter Choices for Better Health, organized a workshop on “The value of prevention: calculating benefits and costs”. The purpose of the event was to connect researchers and policymakers to make further steps towards a better quantification of the costs and benefits of prevention in the Netherlands. More than sixty people participated.
The event had three main speakers. Michele Cecchini is responsible for the OECD program of work on public health and advises policy makers around the world on policies to prevent unhealthy lifestyles and major risk factors. He talked about the OECD’s SPHeP external model, which is one of the prime examples of how societal costs and benefits, including long-term macro-economic effects, can be estimated and used to inform policy makers on public health policies. He also shared experiences and challenges to influence policy-making.
Professor Ardine de Wit, senior researcher at the National Institute for Public Health and the Environment (RIVM), discussed the recent developments in the Dutch context and the advice of the Expert Committee on the topic. She also talked about the issues arising when doing societal cost-benefit analyses in public health.
Ben Wijnen, who is the head of the Center for Economic Evaluation of the Trimbos Institute, discussed the chances and challenges of evaluating the costs and benefits of specific preventive interventions in practice. Elena Nixdorf (CPB Netherlands Bureau for Economic Policy) and Albert van der Horst (Ministry of Health) kicked off the discussion with the audience on how to get better evidence and ultimately better policies in public health.
The main takeaway from the event was that a broad assessment of all relevant societal costs and benefits is essential, as the impact of public health interventions goes beyond health and health expenditure. Expectations for these interventions should be realistic: although many interventions have a positive societal impact, the effects of single interventions on health, health care spending, and other benefits are often modest. There is still much work to be done to fill current gaps in evidence and methodology. At the same time, a lot of work is already being done, both nationally and internationally, and there is good evidence of positive societal effects for many interventions.
- Associate professor
