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:
- 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;
- 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;
- evaluate the impact on costs and outcomes separately for each of the interventions and combinations thereof if directed at Indigenous Australians; and
- 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)
Risk Factors
Alcohol
- Cobiac LJ, Vos T, Doran C, Wallace A. Cost-effectiveness of interventions to prevent alcohol-related disease and injury in Australia. Addiction 2009;104:1646-1655
- Byrnes J, Cobiac L, Doran C, Vos T, Shakeshaft A. The cost-effectiveness of volumetric alcohol taxation in Australia. Medical Journal of Australia 2010;192:439-443
- Hall W, Wallace A, Cobiac L, Doran C, Vos T. How can we reduce alcohol-related road crashes among young Australians? Medical Journal of Australia 2010;192:464-466
- Doran C, Hall W, Shakeshaft A, Vos T, Cobiac L. Alcohol policy reform in Australia: what can we learn from the evidence? Medical Journal of Australia 2010;192: 468-470
- Doran C, Cobiac L, Byrnes J, Vos T (2010) Alcohol taxation and distribution of gains. National Drug and Alcohol Research Centre, University of New South Wales; Centre for Burden of Disease and Cost-Effectiveness, The University of Queensland; VicHealth; Public Health Association of Australia
Pamphlet 2: Alcohol (PDF, 587KB)
Physical activity
Cobiac LJ, Vos T, Barendregt JJ. Cost-effectiveness of interventions to promote physical activity: a modelling study. PLoS Med 2009;6:e1000110
Pamphlet 11: Physical activity (PDF, 888KB)
Fruits and vegetables
Cobiac LJ, Vos T, Veerman JL. Cost-effectiveness of interventions to promote fruit and vegetable consumption. PLoS ONE 5(11): e14148. doi:10.1371/journal.pone.0014148
Pamphlet 7: Fruit and vegetables (PDF, 1MB)
Salt
Cobiac LJ, Vos T, Veerman JL. Cost-effectiveness of interventions to reduce dietary salt intake. Heart 2010;96:1920e1925. doi:10.1136/hrt.2010.199240
Multi-component
Cobiac LJ, Vos T, Veerman JL. Cost-effectiveness of Weight Watchers and the Lighten Up to a Healthy Lifestyle program. Aust N Z J Public Health 2010;34(3):240–247
Body mass
- Forster M, Veerman JL, Barendregt JJ, Vos T. Cost-effectiveness of diet and exercise interventions to reduce overweight and obesity. International Journal of Obesity, advance online publication 11 January 2011; doi: 10.1038/ijo.2010.246
- Veerman JL, Forster M, Barendregt JJ, Vos T. Cost-Effectiveness of Pharmacotherapy to Reduce Obesity. PLoS ONE 6(10): e26051. 27 Oct 2011. doi:10.1371/journal.pone.0026051
- Sacks G, Veerman JL, Moodie M, Swinburn B. Traffic-light’ nutrition labelling and ‘junk-food’ tax: a modelled comparison of cost-effectiveness for obesity prevention. International Journal of Obesity, advance online publication 16 November 2010; doi: 10.1038/ijo.2010.228
- Lee YY, Veerman JL, Barendregt JJ. The Cost-Effectiveness of Laparoscopic Adjustable Gastric Banding in the Morbidly Obese Adult Population of Australia. PLoS ONE 8(5): e64965. doi:10.1371/journal.pone.0064965
Pamphlet 9: Obesity (PDF, 1MB)
Blood pressure and cholesterol
- Cobiac LJ, Magnus A, Lim S, Barendregt JJ, Carter R, Vos T. Which interventions offer best value for money in primary prevention of cardiovascular disease? PLoS One. 2012;7(7):e41842. Epub 2012 Jul 23
- Cobiac LJ, Magnus A, Barendregt JJ, Carter R, Vos T. Improving the cost-effectiveness of cardiovascular disease prevention in Australia: a modelling study. BMC Public Health. 2012 Jun 1;12(1):39
Pamphlet 3: Blood pressure and cholesterol lowering (PDF, 101KB)
Bone mineral density
- Briefing paper: Screen + alendronate (PDF, 58KB)
- Briefing paper: Screen + raloxifene (PDF, 58KB)
- Briefing paper: Physical activity via mass media campaign (PDF, 54KB)
Non-communicable diseases
Illicit drugs
- Briefing paper: CBT for cannabis use disorders (PDF, 138KB) and summary CBT cannabis (PDF, 115KB)
- Briefing paper: School-based drug prevention – Gatehouse (PDF, 159KB)
- Briefing paper: Roadside drug-testing (PDF, 387KB)
- Briefing paper: Non-school-based cannabis use prevention (PDF, 221KB)
Pamphlet 4: Cannabis (PDF, 893KB)
Cervical cancer
Briefing paper: Cervical cancer (PDF, 346KB)
Pamphlet 5: Cervical cancer screening, SunSmart and PSA screening (PDF, 446KB)
Pre-diabetes
Bertram MY, Lim SS, Barendregt JJ, Vos T. Assessing the cost-effectiveness of drug and lifestyle intervention following opportunistic screening for pre-diabetes in primary care. Diabetologia 2010 May;53(5):875–881
Chronic kidney disease
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
- Pamphlet Indigenous 1: Cardiovascular disease prevention (PDF, 1MB)
- Pamphlet Indigenous 2: Diabetes prevention (PDF, 567KB)
- Pamphlet Indigenous 3: Screening and early treatment of chronic kidney disease (PDF, 1MB)