Now that I have your attention, I do know that some primary prevention actually costs money. The two big primary preventions that do save money are smoking cessation and weight loss. Of course those are both very difficult to achieve.
But I believe (and cannot remember studies to the contrary) that most secndary prevention does save money. A few examples off the top of my head – ACE inhibitors and beta-blockers for CHF – treating hypertension – improving diabetes control – statins for diabetics and patients with vascular disease.
Fortunately we can use predominantly generic drugs for these secondary prevention treatments. Unfortunately, appropriate secondary prevention occurs better if outpatient physicians have enough time to develop an ongoing relationship and teach patients the importance all these drugs. They also need enough time to follow targets for each activity.
They need counseling time for smoking and weight loss. While they will not get huge results, a good physician does improve the probability that patients will stop smoking and exercise (hopefully also losing weight.)
{ 2 comments… read them below or add one }
No, not even secondary prevention actually saves money in the long run. Assuming you are able to prevent every cardiovascular event and every complication from diabetes, these patients will then live long enough to contract some other fatal condition (cancer for example) which will then be more expensive to treat than if the patient had died years earlier from CHD or diabetes.
The correct answer is that preventive care does not save money, but is still a good idea. We need to make it as clear as we can to our patients and those in politics that the role of preventive care is to enhance quality of life, NOT to save money.
Prevention is not really to save money but to help you AVOID circumstances.
{ 1 trackback }