The cost-effectiveness of public health interventions: positive findings reported


It is imperative for the NHS to make best possible use of limited resources and the health and economic effects of lifestyle diseases are significant.

The economic case for public health interventions … hitherto has lacked a systematic compilation of evidence … that would allow informed decisions about the allocation of resources between prevention and treatment options, and between options within prevention options


Cost-effectiveness estimates using English cost data were collected and analysed from 21 (of 26) economic analyses that underpin public health guidance published by NICE, 2006 -2010. The papers included base-case cost–utility analyses (based on a cost per quality-adjusted life year).


  • 200 base-case cost-effectiveness estimates were analysed:
  • 15% were cost saving
  • 85% were cost-effective at a threshold of £20 000 per QALY
  • 89% were cost-effective at the higher threshold of £30 000
  • A further 5.5% were cost-effective above £30 000
  • In 5.5% the intervention was more costly and less effective than the comparator


This synthesis of available economic evidence has shown that the vast majority of public health interventions considered thus far by NICE are a highly cost-effective use of public funds.

The authors note that it would be that a next challenge would be to develop a transparent rationale for investment in specific public health interventions, hence providing a commissioning framework that combines evidence from economic analyses with other criteria to support better investment decisions


Owen L, Morgan A, Fischer A, Ellis S, Hoy A, Kelly MP. The cost-effectiveness of public health interventions.  J Public Health (Oxf). 2011 Sep 20. [Epub ahead of print] [PubMed Abstract]

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