Preventive Care: The fallacy of the cost effectiveness of mass screenings.

Suppose there is a disease or condition that could be “cured” for $500 if identified early but would cost $10,000 to treat if not found until in an advanced state.

And suppose there was a screening procedure that could be administered widely to the general public at a cost of $100 each screening.

Now suppose that the disease or condition typically occurs in 1 in 1,000 people.

Do the math.

If you screen 1,000 people at $100 each, you will spend $100,000 to screen all of them, and you will find 1 person with the disease or condition. You can then do the early procedure to cure that person at a cost of $500 and prevent spending the $10,000 it would have cost if the disease or condition had been allowed to progress.

The saving on that ONE patient is $9,500.

But you had to spend $100,000 to find that saving. So the NET cost/saving is a COST of $90,500 to find and treat that one case.

The MOST COST EFFECTIVE strategy is to screen no one. Just by the numbers, curing the 1 person who will develop the advanced stage in this example will cost $10,000, a saving of $90,000 over screening that person plus 999 others who will need no treatment at all.

And that is not even to consider the huge saving possible if, without any screening for any various potentially fatal diseases or conditions, the affected people simply DIE of the disease or condition (as they used to long ago) and take themselves out of the budget altogether.

See also : “Preventive care not always cost effective, experts say” at cnn.com