Health economics: a guide for public health teams

Updated resources to help local commissioners achieve value for money by estimating the return on investment (ROI) and cost-effectiveness of public health programmes | Public Health England

This guide provides links to tools and reports that can help:

  • assess which interventions provide the best value for money, by calculating their costs, benefits and ROI
  • make the most of your budget by deciding how to split resources across different public health programmes
  • compare costs, savings and clinical outcomes

These evidence resources are relevant for local decision makers as well as national policymakers.  The resources have been updated in May 2018, and can be used to estimate the value of investing in prevention and early diagnosis in your area. They pull together the best available evidence on costs, savings, and health benefits for specific topic areas in a single place, thus simplifying the process of commissioning cost-effective services.

The interactive tools produced by PHE are:

Full detail at Public Health England


The economic and wellbeing value of parks and green spaces

Revaluing Parks and Green Spaces | Fields in Trust

autumn-1877749_1920.jpgThis new report highlights that everyone, irrespective of who they are and where they live should have the right to enjoy and benefit from local parks and green spaces. Parks and green spaces are proven to help people stay physically and mentally well; places where we can all move, breathe, run and play. They are an important tool to drive social
cohesion, combat loneliness and build community spirit.

The report presents data on the economic value of parks and green spaces, enabling local authorities for the first time to make a robust, evidence-led business case for the economic and wellbeing value of parks and green spaces to local communities.

This research will enable a strategic approach to the provision of parks and green spaces by identifying areas where investment will have the most significant impact on individuals.  It presents a new and compelling argument that, in a difficult economic climate, the provision of parks and green spaces should be prioritised in areas with lower socio-economic groups and a higher representation of BAME communities given the disproportionately high level of benefits that these groups derive from parks and
green spaces.

Key findings:

  • The Total Economic Value to an individual is £30.24 per year (£2.52 per month), and includes benefits gained from using their local park or green space.
  • The Wellbeing Value associated with the frequent use of local parks and green spaces is worth £34.2 billion per year to the entire UK adult population.
  • Parks and green spaces are estimated to save the NHS around £111 million per year based solely on a reduction in GP visits and excluding any additional savings from prescribing or referrals.

Full report: Revaluing Parks and Green Spaces | Fields in Trust

Alcohol and drugs prevention, treatment and recovery: why invest?

A new resource by Public Health England (PHE) poses this question, to support local commissioners, providers and healthcare professionals to make the case for investing in drug and alcohol treatment and interventions. 

Source: Public Health England

They have produced a set of 32 slides, like the example above which can be downloaded and shared in presentations.

All the Why invest? slides are available from PHE to download here 

There is more guidance on PHE’s website

Health economics: evidence resource

This resource provides a summary of economic evidence underpinning public health interventions

The health economic evidence resource  tool shows the key cost-effectiveness and return on investment evidence on activities in the public health grant.

Each piece of evidence is summarised across over 20 criteria to provide details on how the results were created and to highlight the inputs and assumptions used in the original studies. This allows users to understand the relevance and apply the evidence to their local setting.

Also updated is Health economics: a guide for public health teams. This guide includes health economics evidence and tools that can help:

  • calculate the best public health investments or disinvestments in your local area
  • compare costs, savings and clinical outcomes



Public health interventions may offer society a return on investment of £14 for each £1 spent

Each £1 invested in public health interventions could offer an average return on investment to the wider health and social care economy of £14 | NIHR Signal


This systematic review looked at 52 studies where the return on each £1 ranged from -£21.3 to £221. Legislative interventions such as sugar taxes, and health protection interventions such as vaccination programmes, gave the highest returns on investment. Interventions such as anti-stigma campaigns, blood pressure monitoring and early education programmes, provided smaller (but still favourable) returns. National campaigns offered greater returns than local campaigns. Falls prevention provided the quickest return, within 18 months.

These findings apply to high-income countries. There are some limitations to the data, as a variety of calculation techniques were used and the quality of the included studies varied. However, these are unlikely to alter the direction or approximate size of these effects. The study shows how cost-effective public health interventions can be and should inspire future research into how to better implement what is already known.

Economic evaluations of seasonal influenza vaccination for the elderly

The Council of the European Union (EU) has recommended that action should be taken to increase influenza vaccination in the elderly population | BMJ Open

Image source: Joe The Goat Farmer – Flickr // CC BY 2.0

Objectives: The aims were to systematically review and critically appraise economic evaluations for influenza vaccination in the elderly population in the EU.

Results: Of the 326 search results, screening identified eight relevant studies. Results varied widely, with the incremental cost-effectiveness ratio ranging from being both more effective and cheaper than no intervention to costing €4 59 350 per life-year gained. Cost-effectiveness was most sensitive to variations in influenza strain, vaccination type and strategy, population and modelling characteristics.

Conclusions: Most studies suggest that vaccination is cost-effective (seven of eight studies identified at least one cost-effective scenario). All but one study used economic models to synthesise data from different sources. The results are uncertain due to the methods used and the relevance and robustness of the data used. Sensitivity analysis to explore these aspects was limited. Integrated, controlled prospective clinical and economic evaluations and surveillance data are needed to improve the evidence base. This would allow more advanced modelling techniques to characterise the epidemiology of influenza more accurately and improve the robustness of cost-effectiveness estimates.

Full reference: Shields. G.E. et al. (2017) Systematic review of economic evaluations of seasonal influenza vaccination for the elderly population in the European Union. BMJ Open. 7:e014847