Return on investment in disease prevention outlined in CDC report

The returns on investment from disease and injury prevention efforts are illustrated in a report released today by CDC that outlines the cost effectiveness of 19 public health strategies, such as bicycle helmet laws, colorectal screening, and vaccination.

Typically, public health measures its victories by the human illness, injury and deaths it prevents. However, the report, "An Ounce of Prevention . . . What are the Returns? Second Edition" takes a pragmatic, business yardstick to public health promotion and prevention strategies.

The report, in concise one-page summaries, presents the cost of disease or injury and the cost-effectiveness of prevention strategies. "An Ounce of Prevention" highlights well-known disease prevention efforts such as mammography and vaccination as well as less well known strategies such as screening young women for chlamydia infection and screening newborns for sickle cell.

"While successful public health interventions are important because of their effectiveness and outcomes, this report demonstrates once again that many interventions are also cost effective," said CDC Director Jeffrey Koplan, M.D., M.P.H. "The strategies highlighted in this report provide excellent value for the money invested and some save money. Decision and policy makers in the health care arena will find this a convenient reference tool."

This report continues the work of the first edition, published in 1993. The first edition did not systematically evaluate the quality of the information cited. CDC produced the second edition with a new emphasis on scientific rigor and standardized methodology. Data for this second edition of the report were taken from scientific studies and published reports. Cost-effectiveness data were selected on a set of criteria designed to identify the best and most recent information available.

"This report gives practical guidance to health care providers, community leaders and employers on ways to spend limited health care dollars and to see the returns on their investments, the most important outcome being improved health in their community," said Mark Messonnier, an economist in CDC's Prevention Effectiveness Branch.

The report not only captures the effectiveness of 19 strategies, it also projects the costs and effects that accrue from each strategy during a person's lifetime. For example, diabetes accounts for 12,000 to 24,000 new cases of blindness each year. Early detection and intervention can reduce the incidence of severe vision loss 50 to 90 percent. The suggested screening and treatment for diabetic retinopathy costs $1,757 per life-year of sight gained or $3,190 per quality-adjusted life-year gained. Experts concluded, therefore, that screening for diabetic retinopathy is highly cost effective.

An "Ounce of Prevention" will be released March 19, 1999 through publication in the April issue of the American Journal of Preventive Medicine. It also will be made available to participants at "Prevention 99", the conference of the American College of Preventive Medicine and the Association of Teachers of Preventive Medicine, in Washington, D.C.

Note: A copy of the report will be available online at http://www.cdc.gov/epo/prevent.htm.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES