Assessing Cost Effectiveness (ACE) in Prevention Study

Background

ACE Prevention was a large, 5-year study funded by the National Health and Medical Research Council (NHMRC) and jointly led by Professor Theo Vos of the Centre for Burden of Disease and Cost-Effectiveness at The University of Queensland and Professor Rob Carter of the Deakin Health Economics Unit at Deakin University. The final report was presented on 8 September 2010.

The overall aim of this project was to provide a comprehensive analysis of the comparative cost-effectiveness of preventive intervention options addressing the non-communicable disease burden in Australia, with a specific focus on Indigenous Australians.

ACE Prevention is the most comprehensive evaluation of health prevention measures ever conducted world-wide, involving input from 130 top health experts. The research team assessed 123 illness prevention measures to identify those which will prevent the most illness and premature deaths and those that are best value for money. For comparison purposes 27 treatment interventions were included. To ensure maximum comparability between the results for different interventions, an ACE Prevention Economic Protocol (PDF, 600KB) was developed.

Objectives

The objectives of ACE Prevention were to:

1. assess the relative cost-effectiveness of a comprehensive set of preventive interventions for non-communicable disease in Australia, together with a selected set of comparator care/cure interventions, as a critical input to resource allocation decisions in the health sector;
2. recommend a ‘menu’ of cost-effective interventions from which policy makers can choose an optimal mix of preventive interventions for non-communicable disease control within the constraints of current budgets allocated to prevention, and alternative scenarios of budgetary provision;
3. evaluate the impact on costs and outcomes separately for each of the interventions and combinations thereof if directed at Indigenous Australians; and
4. strengthen the use of evidence in health priority setting in by increasing the capacity among key stakeholders to more effectively incorporate research findings into policy and programme debates taking into account issues of equity, acceptability to stakeholders and feasibility of implementation.

Final report

The final report provides a comprehensive overview of the findings of ACE Prevention.

Download the ACE Prevention final report (PDF, 3MB)

Topics

Methods

• Pamphlet A: The ACE–Prevention project (PDF, 587KB)
• Pamphlet B: ACE approach to priority-setting PDF, 798KB)
• Pamphlet C: Key assumptions underlying the economic analysis (PDF, 703KB)
• Pamphlet D: Interpretation of ACE–Prevention cost-effectiveness results (PDF, 746KB)
• Pamphlet E: Indigenous Health Service Delivery (PDF, 517KB)
• Economic Protocol (PDF, 538KB)

Overall results

• Presentation on the project's findings (PDF, 459KB) - from the September 2010 launch
• League table (PDF, 972KB)
• Combined effects (PDF, 1.18MB)

Chronic kidney disease

Pamphlet 14: Renal replacement therapy, screening and early treatment of chronic kidney disease (PDF, 831KB)

Mental health

• Mihalopoulos C, Carter R, Pirkis J, Vos T. (2013) Priority-Setting for Mental Health Services, Journal of Mental Health, 2013 Apr;22(2):122-34
• Mihalopoulos C, Vos T, Pirkis J, Carter R. (2012) The population cost-effectiveness of a preventive intervention for childhood depression. Pediatrics, published online 6th Feb
• Mihalopoulos C, Vos T, Pirkis J, Smit F, Carter R. (2011), Do indicated preventive interventions for depression represent good value for money? Australian and New Zealand Journal of Psychiatry, Vol 45(1), 36-44
• Mihalopoulos C, Vos T, Pirkis J, Carter R. (2011) The Economic Analysis of Prevention in Mental Health Programs, Annual Review of Clinical Psychology, 7, 169-201

• Briefing paper: Childhood anxiety (ACE Steering Committee only; part of PhD work) 
• Briefing paper: Childhood depression (ACE Steering Committee only; part of PhD work)
• Briefing paper: Youth psychosis (ACE Steering Committee only; part of PhD work)
• Briefing paper: Depression screening (ACE Steering Committee only; part of PhD work)
• Briefing paper: Post-partum depression (ACE Steering Committee only; part of PhD work)
• Briefing paper: Suicide prevention (ACE Steering Committee only; part of PhD work)
• Briefing paper: Depression treatment (PDF, 248KB)

• Pamphlet 1: Adult depression (PDF, 744KB)
• Pamphlet 6: Childhood mental disorders (PDF, 735KB)
• Pamphlet 13: Psychosis (PDF, 646KB)
• Pamphlet 16: Suicide prevention (PDF, 617KB)

Vision loss

• Briefing paper: Vision screening (PDF, 94KB)
• Briefing paper: Ranibizumab for AMD (PDF, 221KB)

Oral health

Cobiac LJ, Vos T. Cost-effectiveness of extending the coverage of water supply fluoridation for the prevention of dental caries in Australia. Community Dent Oral Epidemiol 2012. Epub online: 27 MAR 2012

Briefing paper: Regular dental checks for adolescents (PDF, 64KB)

Osteoarthritis

Higashi H, Barendregt JJ (2011) Cost-Effectiveness of Total Hip and Knee Replacements for the Australian Population with Osteoarthritis: Discrete-Event Simulation Model. PLoS ONE 6(9): e25403. doi:10.1371/journal.pone.0025403

• Briefing paper: Osteoarthritis hip and knee (PDF, 124KB)
• Briefing paper: Osteoarthritis hip and knee - appendix (PDF, 175KB)

Communicable diseases

Shingles

Briefing paper: Varicella zoster vaccination (PDF, 121KB)

Influenza

Mogasale V, Barendregt JJ. Cost-effectiveness of influenza vaccination of people aged 50-64 year in Australia: results are inconclusive. ANZPH, 2011;35 (2):180-6
(With comments in a letter from Newall & Scuffham and response from Mogasale & Barendregt)

HIV 

Pamphlet 8: Cost-Effectiveness of HIV Interventions (PDF, 604KB)

Indigenous

Indigenous results

Ong K, Kelaher M, Anderson I, Carter R. A cost-based equity weight for use in the economic evaluation of primary health care interventions: case study of the Australian Indigenous population. International Journal for Equity in Health 2009, 8:34