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Disease Prevention: Saving Lives or Reducing Health Care Costs?

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  • Inge Grootjans-van Kampen
  • Peter M Engelfriet
  • Pieter H M van Baal

Abstract

Background: Disease prevention has been claimed to reduce health care costs. However, preventing lethal diseases increases life expectancy and, thereby, indirectly increases the demand for health care. Previous studies have argued that on balance preventing diseases that reduce longevity increases health care costs while preventing non-fatal diseases could lead to health care savings. The objective of this research is to investigate if disease prevention could result in both increased longevity and lower lifetime health care costs. Methods: Mortality rates for Netherlands in 2009 were used to construct cause-deleted life tables. Data originating from the Dutch Costs of Illness study was incorporated in order to estimate lifetime health care costs in the absence of selected disease categories. We took into account that for most diseases health care expenditures are concentrated in the last year of life. Results: Elimination of diseases that reduce life expectancy considerably increase lifetime health care costs. Exemplary are neoplasms that, when eliminated would increase both life expectancy and lifetime health care spending with roughly 5% for men and women. Costs savings are incurred when prevention has only a small effect on longevity such as in the case of mental and behavioural disorders. Diseases of the circulatory system stand out as their elimination would increase life expectancy while reducing health care spending. Conclusion: The stronger the negative impact of a disease on longevity, the higher health care costs would be after elimination. Successful treatment of fatal diseases leaves less room for longevity gains due to effective prevention but more room for health care savings.

Suggested Citation

  • Inge Grootjans-van Kampen & Peter M Engelfriet & Pieter H M van Baal, 2014. "Disease Prevention: Saving Lives or Reducing Health Care Costs?," PLOS ONE, Public Library of Science, vol. 9(8), pages 1-5, August.
    • Handle: RePEc:plo:pone00:0104469
    DOI: 10.1371/journal.pone.0104469
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    References listed on IDEAS

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    1. Albert Wong & Pieter H. M. van Baal & Hendriek C. Boshuizen & Johan J. Polder, 2011. "Exploring the influence of proximity to death on disease‐specific hospital expenditures: a carpaccio of red herrings," Health Economics, John Wiley & Sons, Ltd., vol. 20(4), pages 379-400, April.
    2. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    3. Pieter H M van Baal & Johan J Polder & G Ardine de Wit & Rudolf T Hoogenveen & Talitha L Feenstra & Hendriek C Boshuizen & Peter M Engelfriet & Werner B F Brouwer, 2008. "Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure," PLOS Medicine, Public Library of Science, vol. 5(2), pages 1-8, February.
    4. Peter Zweifel & Stefan Felder & Markus Meiers, 1999. "Ageing of population and health care expenditure: a red herring?," Health Economics, John Wiley & Sons, Ltd., vol. 8(6), pages 485-496, September.
    5. Kanters, Tim A. & Brouwer, Werner B.F. & van Vliet, René C.J.A. & van Baal, Pieter H.M. & Polder, Johan J., 2013. "A new prevention paradox: The trade-off between reducing incentives for risk selection and increasing the incentives for prevention for health insurers," Social Science & Medicine, Elsevier, vol. 76(C), pages 150-158.
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