WASHINGTON, Feb. 25, 2009 – Disease prevention and health promotion programs provide good value to the health care system, but the Congressional Budget Office has largely overlooked this in its assessment of potential health reforms, according to a white paper released today by Partnership for Prevention.

The white paper, prepared by some of the nation’s leading authorities on public health and prevention, called recent CBO assessments of prevention programs “short-view, narrowly focused analyses” that “tabulate the often sizable upfront costs of covering preventive services but ignore their subsequent payback over time.” The paper is available online at http://www.prevent.org/images/stories/PolicyPapers/prevention%20cost-effectiveness.pdf .

“The challenge of health reform is to make sure we get our money’s worth from the health care system,” said Dr. Corinne G. Husten, interim president of Partnership for Prevention, in releasing the white paper. “But when it comes to disease prevention and health promotion, the CBO has missed the point. They don’t measure value, and instead treat prevention as a dispensable luxury. Prevention is the only reform that truly improves people’s health while also controlling rising costs.”
 
The white paper, entitled “The Economic Argument for Disease Prevention: Distinguishing Between Value and Savings,” was jointly authored by Husten and five of the nation’s leading authorities on public health and prevention.

“Unsustainable growth in medical spending has sparked interest in the question of whether prevention saves money and could be the answer to the health care crisis,” they wrote. “But the question misses the point. What should matter for both prevention and treatment services is value - the health benefit per dollar invested.”

As part of two December reports on health reform, the CBO looked extensively into the question of whether prevention programs save money.  In many cases, it concluded that greater use of preventive medical care “could improve people’s health, but would probably generate either modest reductions in the overall costs of health care or increases in such spending within a 10-year budgetary time frame.”

In some cases, it said, prevention programs that improve health and extend people’s life span “could cause federal expenditures for retirement benefits and Medicare to increase in the longer term.”

The authors of the white paper said a relatively small number of preventive services – such as childhood vaccines and smoking cessation programs – promptly yield net savings, but other core preventive services still represent a good health care value. They noted that the National Commission on Prevention Priorities studied 25 strongly recommended preventive services and found that 15 of them cost less than $35,000 per quality-adjusted life year gained (QALY) and 10 of them cost less than $14,000 per QALY.

“Whereas the mainstays of disease care (e.g., angioplasty) can cost payers $100,000 per QALY or more, most evidence-based preventive services are a better value,” they wrote.

Joining Husten in authoring the paper were: Dr. Steven H. Woolf, Professor of Family Medicine at Virginia Commonwealth University; Lawrence S. Lewin, executive consultant and founder of the noted Lewin Group; Dr. James S. Marks, Senior Vice President at the Robert Wood Johnson Foundation; Dr. Jonathan E. Fielding, Director of Public Health at Los Angeles County Department of Public Health; and Dr. Eduardo J. Sanchez, former Texas Health Commissioner who is now current Vice President and Chief Medical Officer at Blue Cross and Blue Shield of Texas.

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Partnership for Prevention is a non-partisan, non-profit organization of business, health care, and government leaders who are working to make disease prevention and health promotion a higher priority in the nation’s health policies and programs. More information is available at www.prevent.org .