Health promotion and cost-effectiveness

Successful health promotion may save resources but this is not its main objective. Health promotion programmes which cost more than they save may still be an economically efficient way of reducing premature death and improving quality of life. The principles of health economics emphasise how scarcity makes resource allocation choices inescapable. They highlight the fact that the benefits from health promotion are achieved at the sacrifice of potentially achievable benefits elsewhere. The thinking of economics and the techniques of economic appraisal can help to show how more efficient choices between health promotion and other health producing interventions, as well as choices within health promotion, can be made. One major problem with applying economic appraisal to health promotion is the way in which the technique reduces the value of future benefits to account for the lower value which society appears to place on future versus current benefits (and costs). Emphasising the peace-of-mind benefits of health promotion, which arise immediately as a result of the knowledge that risks are reduced, is one way of partly overcoming the accusation that economic appraisals discriminate against health promotion in favour of treatment and cure. A plea is made for greater use of economics in health promotion.