Personalizing Preventive Medicine To Improve Cost-Effectiveness

Personalizing Preventive Medicine To Improve Cost-Effectiveness
A majority of healthcare spending is for largely preventable chronic diseases, and we are therefore seeing more and more focus on preventive medicine. The aim is to either prevent the occurrence of a disease or halt and avert resulting complications after its onset.

Most people agree that preventive care is important, and has in fact been key in advancing our health. Just take a look at how clean water and sanitation has added decades to the average lifespan, and vaccination campaigns have reduced infant mortality. As a result, the search for new public health measures that can improve overall health goes on.

Now a new study has found that a routine blood test can help measure a patient’s future risk for chronic diseases, including diabetes, kidney failure, dementia, chronic obstructive pulmonary disease and multiple heart diseases. That pretty much sounds like the holy grail of healthcare. Identify patients at high risk of multiple diseases, help them avoid getting sick, while decreasing healthcare costs. While the study provide an interesting solution that could help advance our health, it also highlight key challenges of preventive medicine.

Although there are cultural differences around the world on how healthcare services are used, most people go to the doctor because something specific is bothering them. Then should the doctor spend resources on something that is unrelated to what the patient actually came in for? And do all people want to know their risk of developing certain diseases, or will such a test cause more harm than good? Will it have an impact on insurance? Will it cause anxiety and stress, reducing quality of life, or will it be perceived as an opportunity to improve health? The answer is likely in how effective available preventive measures are. If a preventive strategy for a specific disease is effective, then patients are more likely to use them, adhere to them, and feel less anxiety towards knowing whether or not they are at future risk of a disease.

However, some of the best-known forms of preventive care does not actually improve someone’s health. For example, annual physicals has been found not to lower risk of serious illness or premature death, and some cancer screenings produce essentially no health benefits. In addition, some low-cost strategies proven to be effective, such as lifestyle interventions, might be difficult to adhere to, if people are willing to even try them.

The economic argument, the assertion that you can cut healthcare spending through preventive care is widely misunderstood. One of the major reasons why so many preventive strategies fail to reduce costs is the large number of people who need to receive a particular preventive service in order to avert a single expensive illness. There are of course prevention programs that do produce net savings, such as childhood immunizations, but these are in fact considered exceptions. The cost of providing them to everyone is less than that of treating the illnesses they prevent. The truth is that, preventive measures can be very expensive, and the number of people that you need to screen in order to prevent one case of illness can be huge.

This is why the new study is so interesting. While introducing the blood test to patients could be challenging, it might in fact have great impact on the future of preventive medicine. Using a blood test to measure a patient's future risk for chronic diseases could help deliver targeted preventive care. Instead of providing services to a large group who will not benefit from it, which is one of the major reasons why so many preventive measures fail to show cost-effectiveness, such a blood test could personalize preventive care. By using this ‘smart’ approach to specifically identify with a high certainty who will develop a disease, we are increasing our chances of preventing expensive diseases and saving money.