[Economic aspects of prevention].

This paper deals with health economic aspects of prevention. After giving a definition of the term prevention, published estimates of the burden of disease attributable to selected risk factors are presented. These estimates suggest that a considerable share of morbidity, mortality and health care costs may be avoided through prevention. Subsequently, the paper describes the methods that can be used to analyze the cost-effectiveness of preventive services. Typical problems arise from the necessity to estimate long-term costs and effects, which often requires modeling. A specific problem refers to whether so-called unrelated future health care costs caused by other diseases in life years gained through prevention should be included when calculating the costs of prevention. Economic evaluations of preventive services published in the literature often report very favorable cost-effectiveness ratios. In order to increase the efficiency of health care, more cost-effective preventive services should be developed and used.