Health benefits through prevention: there is still a lot to be gained

Abstract

Abstract Introduction In November 2018, the Ministry of Health, Welfare and Sports presented the National Prevention Agreement (NPA). Within this NPA, interventions targeting smoking, being overweight and problematic alcohol use were proposed to induce lifestyle changes. In addition to measures aimed at these three themes, there is also a range of interventions that are promising, either because they could be cost saving or cost-effective, or because they have a positive impact on burden of disease. We explored which preventive interventions are promising in the Dutch context and systematically quantified costs, savings and health effects. Methods In a literature search via the website kosteneffectviteitvanpreventie.nl we selected interventions that: a) have not yet been introduced in the Netherlands; and b) were promising with respect to effectiveness and cost-effectiveness. All interventions, including health protection and environmental measures, were eligible. We estimated the number of people who are eligible and compliant, costs and possible savings related to the interventions and health effects in terms of DALYs avoided. Interventions were ranked with regard to possible savings and DALYs avoided. Results Our exploration shows a number of preventive interventions that are cost saving or cost-effective. These interventions are aimed at anxiety and depression, heart disease, skin cancer, fractures, air quality and road safety. Examples of cost-saving or cost-effective interventions are a food tax on food and drinks with high fat/sugar content, screening an aneurysm of the aorta and fully subsidized sound insulation of homes. Conclusions Our study shows that there are much more preventive opportunities than those presented in the NPA. The substantiation of the interventions is often based on foreign research and findings therefore cannot be simply translated to the Netherlands. However, the interventions identified in this study are promising and deserve further consideration. Key messages Health gain by environmental measures. Many interventions are not systematically implemented.