Prioritising investment in public health: Translating cost-benefit analysis evidence for policy makers

Article type
Authors
Marsh K1
1The Matrix Knowledge Group, London, UK
Abstract
Background: It is often stated that decisions to invest public resources should be informed by effect and economic evidence. This objective faces two challenges. First, many fields suffer from a paucity of evaluation work. Second, even in fields where evidence of cost-effectiveness is available, such as healthcare, it only has limited impact on policy making. Objective: This paper presents the results of a project to ‘translate’ and present effectiveness and economic evidence so that it is more relevant and accessible to decision makers. Specifically, the objective is to develop and apply a methodology to prioritise investments in public health interventions. Method: The method employed comprised the following steps: 1. Engagement with decision makers to identify interventions to include in the analysis, and the criteria against which they should be assessed. 2. Reviews of the evidence. 3. Construction of economic models. 4. A discrete choice experiment. 5. The development of a web tool to allow decision makers to localise the results of the analysis and to benchmark other interventions against those included in the analysis. Results: 14 public health interventions were included in the tool. The results suggest that: 1. Increasing tax on cigarettes and alcohol, mass media campaigns, and brief interventions delivered by GPs perform well in meeting decision makers’ objectives. 2. Screening retirees for depression and providing support to carers with depression perform relatively badly at meeting decision makers’ objectives. Conclusion: The project provides information that is useful to public health decision makers. Perhaps more importantly it demonstrates the proof of concept of a tool to facilitate decision makers’ access to and use of evidence.