Is a Pound of Prevention Worth an Ounce of Cure?

It is largely believed that investments in preventive measures will lead to improved health outcomes and reduced resource use. In a synthesis of economic evidence of preventive and treatment services, Cohen et al. suggest that “Although some preventative measures do save money, the vast majority reviewed in the health economics literature do not.”¹ Their research suggests that sweeping generalizations about the value of preventive medicine is not supported by empirical research and that “careful analysis of the costs and benefits of specific interventions…is critical.”¹ Most importantly, their research also indicates that the value of preventive measures is similar to that of treatment. These findings suggest an ounce of prevention might only be worth an ounce of cure.

In a more recent examination of the value of prevention, Cohen and Neumann further suggest that cost-saving interventions, such as child immunizations, are already in widespread use, and “it is unlikely that substantial cost savings can be achieved by increasing the level of investment in clinical preventive measures.”² The authors identify those services that are cost-saving or represent better and worse value for money. Although counselling women to use calcium supplements was identified as of potentially good value, examples of preventive measures of poor value include adult tetanus-diphtheria booster shots every 10 years and screening of women for osteoporosis.

¹ Cohen JT, et al. NEJM 2008; 358(7): 661-663.

² Cohen JT, et al. Robert Wood Johnson Foundation. Research Synthesis Report 18.