What Is the ROI from A Preventive Healthcare Approach?

What is the ROI from preventive healthcare? This is a question many of us have encountered, especially the main stakeholders in governments, insurance companies, human resources departments, medical doctors, and of course, finance executives who evaluate investments based on ROI.

Return on investment (ROI) is a performance measure used to evaluate the efficiency or profitability of an investment or compare the efficiency of a number of different investments. ROI tries to directly measure the amount of return from a particular investment, relative to the investment’s cost (Fernando, 2022).

Why should we focus on prevention?

Historically, we’ve managed healthcare by treating diseases and expecting that someday this would lower expenses. The reality is that the healthcare industry has been focused on lowering the costs of drugs, procedures and medical devices that will lower the cost of treating diseases but it has not focused on promoting health by promoting changes in behavior.

The new challenge we encounter is that the epidemiological transition has changed into what we know now as noncommunicable diseases (NCDs), which are not cured entirely with drugs, procedures and medical devices. These diseases, including cardiovascular diseases, cancer, diabetes, chronic respiratory diseases and mental disorders, are the leading causes of death worldwide and carry a huge cost that extends beyond health to undermine workforce productivity and economic prosperity (WHO, 2018).

For the first time, the financing needs for tackling NCDs in low- and lower middle-income countries have been calculated and translated into health and economic returns. We’re all invited to view tackling NCDs as an opportunity to achieve better health outcomes and improved economic performance. If all countries put in place the most cost-effective interventions, by 2030 they would not only save millions of lives but also see a return of US$7 per person for every dollar invested (WHO, 2018).

Part of the problem comes from a misconception: governments and main health stakeholders tend to accept deaths from NCDs as unavoidable – but they are not. A different strategy for a better future is possible. We can lower the incidence of NCDs and the suffering they cause. In addition, a relatively small investment can help to prevent enormous costs.

What’s the value of preventing and controlling NCDs?

Investing in prevention and control not only improves health and saves lives, but can also improve a country’s economic productivity. It can improve workforce participation and productivity, and the financial costs of unexpected diseases on individuals and families.

What are the best investments?

The next six interventions proposed are both cost-effective and achievable for governments and countries to implement. These interventions show the best evidence of generating impact and value – for health, the economy and other areas of development.

These interventions are stronger and more beneficial when used together. For example: campaigns that promote physical activity and low-salt food options are more likely to reduce people’s long-term risk of developing cardiovascular disease.

1. Promote a healthy diet:
   • Educate the population to enhance a change in behavior.
   • Create supportive environments in public institutions, such as hospitals, schools, workplaces.
   • Provide detailed information on labels of packaged foods to provide more information about what we’re eating.
   • Reformulate food and limit levels of sugar and salt.
2. Promote physical activity:
   • Implement education and awareness campaigns, including mass media campaigns combined with community-based education, motivational and environmental programs focused on supporting behavioral change.
3. Reduce harmful use of alcohol:
   • Enforce bans and restrictions on exposure to alcohol advertising across media.
   • Enforce restriction on physical availability of alcohol and hours of sale.
   • Increase tax on alcoholic beverages.
4. Reduce tobacco use:
   • Educate on the health-related risks of smoking and second-hand smoke.
   • Enforce bans and restrictions on exposure to tobacco advertising across media.
   • Implement changes in packaging, creating awareness about lifestyle health diseases that people can identify.
   • Eliminate the exposure to second-hand smoke in all indoor workplaces, public places and transport.
   • Increase tax on tobacco products.
5. Prevent and manage chronic diseases:
   • Provide drug therapy counseling for individuals at high risk of a fatal and non-fatal cardiovascular event. Provide counseling regarding glycemic control for diabetes patients.
   • Provide education and awareness of how chronic diseases can be prevented and treated.
6. Prevent and manage cancer:
   • More screening, starting from age 30, especially regarding prevention of breast and cervical cancer that are the main causes of death throughout our populations. With a correct screening guideline, cancer can be detected at an early stage, save lives and reduce catastrophic costs.

How can we start?

These six actions are the most achievable and cost-effective interventions to prevent and control NCDs. For an additional investment of up to US$1.27 per person per year between now and 2030, substantial progress on the health of our population can be achieved.

I invite you to question if the root cause in this matter is the lack of drugs, surgeries and medical devices, or is it our own lifestyle/behavior that has translated greatly into the growth of NCDs and chronic diseases.