title: Secondary prevention fallacy: pitfalls in comparing with primary.
abstract: A basic tenet of our culture is the idea that preventing ills is better than curing them. This principle is entrenched in many proverbs and popular admonitions: 'A stitch in time saves nine', 'An ounce of prevention is worth a pound of cure'. These well-worn sayings crisply convey our sense that it is preferable to intervene before a bad event occurs than to wait and try to mitigate it afterwards. Yet, economic analyses have demonstrated that in healthcare this does not hold: 'primary prevention' does not provide as good value-for-money as 'secondary prevention'. Is this reversal of folk wisdom correct? Or, instead, is it a result of faults in the application of the relatively new methodology of cost-effectiveness analyses?
authors.affiliation: jcaro@caroresearch.com
authors.forename: J J
authors.initials: JJ
authors.lastname: Caro
authors.forename: K F
authors.initials: KF
authors.lastname: Huybrechts
authors.forename: W S
authors.initials: WS
authors.lastname: Klittich