Economics of Prevention
Deakin Health Economics has been at the forefront of the economics of prevention for several decades. Our inaugural leader, Professor Rob Carter co-led the seminal Assessing Cost-Effectiveness in Prevention study (ACE-Prevention), the first large scale priority-setting study that evaluated the cost-effectiveness of 123 prevention interventions across 6 preventive risk factors. The study demonstrated that over half the interventions evaluated were either dominant (cost-saving and health promoting over the long-term) or cost-effective. This pioneering work, along with subsequent studies such as ACE-Obesity Policy, has continued to build a compelling economic case for greater investment in prevention.
Australia has previously made bold commitments to preventive health, most notably through the 2008-2018 National Partnership Agreement on Preventive Health (NPAPH) – Australia’s largest investment in prevention, which injected $872 million to address chronic disease risk factors. However, the cessation of funding in 2014 after a change in government highlighted the need for future efforts to have bipartisan support and resilience to shifts in political priorities. While the past decade has seen the development of national strategies that acknowledge the importance of investment in prevention, there has been limited implementation of interventions proven to be both effective and cost-effective.
It is therefore welcomed that the Productivity Commission Inquiry into ‘Delivering quality care more efficiently’ has recommended the establishment of a ‘National Prevention Investment Framework’ supported by an independent, cross-sectoral and cross-jurisdictional advisory board. By explicitly linking Australia’s economic wellbeing to the health of the population, this framework could offer a path to avoiding ideological and partisan debates and lay the foundation for sustained, long-term investment in cost-effective prevention initiatives. We welcome the Productivity Commission’s recommendations and have outlined next steps in a recent commentary published in the Australian New Zealand Journal of Public Health.
Deakin Health Economics continues to be at the forefront of the economics of prevention, with a strong focus on generating evidence to support investment in cost-effective prevention initiatives. Two of our current projects are outlined below.
Multi-criteria decision analysis framework for prevention
We are undertaking a study to develop a multi-criteria decision analysis (MCDA) framework to guide resource allocation for obesity prevention in Australia. The project aims to identify and weight the key considerations that influence preventive health decision-making. We have reviewed the international academic and grey literature to identify relevant decision-making criteria, and we will work with an international advisory group to validate the findings of the review. We will then recruit policymakers across Australia to undertake a conjoint analysis to assign weights for the different decision-making criteria. This MCDA framework will provide a transparent decision-making framework for obesity prevention resource allocation across Australia.
Priority-setting for obesity prevention in South Australia
In collaboration with Preventive Health SA, we are applying Assessing Cost-effectiveness (ACE) methods to support the development of a strategic, evidence-informed approach to obesity prevention in South Australia. This priority-setting study involves a series of workshops with policymakers and obesity prevention experts:
Workshop 1: Developed a framework to map a broad range of interventions
Workshop 2: Identified 10 policy-relevant interventions for further scoping
Workshop 3: Will present findings of detailed scoping reviews to select 5-7 interventions for full economic evaluation
Workshop 4: Will present results of the economic analyses and work with policymakers to place the interventions within a broader MCDA framework (referred to in previous ACE studies as implementation considerations)
