Lack of Cost-Effectiveness Analyses to Address Healthy People 2020 Priority Areas

Am J Public Health. 2016 Dec;106(12):2205-2207. doi: 10.2105/AJPH.2016.303361. Epub 2016 Sep 15.


Objectives: To examine the extent to which recently published cost-utility analyses (cost-effectiveness analyses using quality-adjusted life-years to measure health benefits) have covered the leading health concerns in the US Department of Health and Human Services Healthy People 2020 report.

Methods: We examined data in the Tufts Medical Center Cost-Effectiveness Analysis Registry, a database containing 5000 published cost-utility analyses published in the MEDLINE literature through 2014. We focused on US-based cost-utility analyses published from 2011 through 2014 (n = 687). Two reviewers scanned abstracts and met for a consensus on categorization of cost-utility analyses that addressed the specific priorities listed in the 12 Healthy People 2020 areas (n = 120).

Results: Although 7.3% of recently published cost-utility analyses addressed key clinical preventive services, only about 2% of recently published cost-utility analyses covered each of the following Healthy People 2020 topics: reproductive and sexual health, nutrition/physical activity/obesity, maternal and infant health, and tobacco. Fewer than 1% addressed priorities such as injuries and violence, mental health or substance abuse, environmental quality, and oral health.

Conclusions: Few cost-utility analyses have addressed Healthy People 2020 priority areas.

MeSH terms

  • Cost-Benefit Analysis*
  • Female
  • Health Priorities
  • Health Services Needs and Demand*
  • Healthy People Programs / economics*
  • Humans
  • Male
  • Registries