[Cost-effectiveness of prevention: opportunities for public health policy in the Netherlands].
OBJECTIVE
To gain insight into the cost-effectiveness of new preventive interventions.


METHODS
Systematic review and interviews.


METHODS
Based on literature search, a search of the project database of ZonMw and interviews with experts, the National Institute for Public Health and the Environment drew up a long list of preventive interventions that are potentially cost-effective but are not yet systematically carried out in the Netherlands. From this long list, 21 interventions were selected for each of which, at least 3 economic evaluations were available that indicate favourable cost-effectiveness (< Euro 20,000,--per QALY gained).


RESULTS
The majority of the interventions concerned vaccination and screening programmes (7 and 5 respectively). Only a small minority concerned health promotion or health protection (1 respectively 3). There was strong evidence that 5 interventions were both cost-effective, and feasible. These were: screening for Chlamydia, screening for diabetic retinopathy in type 2 diabetes, screening for neonatal group beta streptococcal infections through a combination strategy, prevention of recurrent myocardial infarction through heart habilitation, and prevention of head injuries by wearing of bicycle helmets by children.


CONCLUSIONS
Before implementation of preventive interventions, it is necessary to investigate whether these interventions are also cost-effective in the Dutch context.
van den Berg
M
M
Rijksinstituut voor Volksgezondheid en Milieu, Bilthoven. matthijs.van.den.berg@rivm.nl
de Wit
G A
GA
Vijgen
S M C
SM
Busch
M C M
MC
Schuit
A J
AJ
D003362:Cost-Benefit Analysis; D006259:Craniocerebral Trauma / Q000517:prevention & control; D006291:Health Policy; D006801:Humans; D008403:Mass Screening / Q000191:economics; D015201:Meta-Analysis as Topic; D011322:Primary Prevention / Q000191:economics / Q000379:methods; D011634:Public Health / Q000191:economics* / Q000379:methods*; D014611:Vaccination / Q000191:economics