Health economics: a guide for public health teams

Resources to help local commissioners achieve value for money by estimating the return on investment (ROI) and cost-effectiveness of public health programmes.

Public Health England (PHE) looks to support local public health decision making by producing accessible health economics resources.

In this guide you will find links to tools and reports that can help you:

  • assess which interventions provide the best value for money, by calculating their costs, benefits and ROI
  • make the most of your budget by deciding how to split resources across different public health programmes
  • compare costs, savings and clinical outcomes

These evidence resources are relevant for local decision makers as well as national policymakers.

The cost-effectiveness of specific topic areas

PHE’s Health Economics team has produced a number of resources which can be used to estimate the value of investing in prevention and early diagnosis in your area. They pull together the best available evidence on costs, savings, and health benefits for specific topic areas in a single place, thus simplifying the process of commissioning cost-effective services.

The interactive tools produced by PHE are:

The ‘Dementia in older age report’ discusses the difficulty in estimating ROI results for primary prevention of dementia. This difficulty is because of the long time periods between people undertaking behaviours that increases risk and the onset of the condition.

Wider decision support

To help local decision makers think about how to split their budget across multiple public health programmes, PHE has developed the Prioritisation Framework. The Framework offers a transparent and evidence based approach to making the most of the available resources in a local authority.

Another resource that helps you think across multiple public health topic areas at once is the health economics evidence resources (HEER). The HEER collects and summarises the economic evidence on a wide selection of public health interventions. Each piece of evidence is categorised against over 20 criteria allowing you to filter and select only what you are interested in. The HEER replaces the previously published menu of preventative interventions.

The fiscal and pricing policies to improve public health report identifies and assesses potential fiscal or pricing policies that could be implemented in England to improve the population’s health. The framework accompanying the report allows policies in different policy areas to be comparable in terms of their impacts on health and other outcomes.

Comparing spend and outcomes

The spend and outcome tool (SPOT) gives a broad overview of spend and outcomes across a range of public health interventions. The SPOT can be used by both CCGs and local authorities.

The tool doesn’t estimate ROI results but you can use it alongside ROI tools. Every CCG and local authority in England has a bespoke factsheet within the tool and you can compare against similar local areas.

Diabetes and cardiovascular disease tools look at the relationship between spending on treatment and care and local clinical outcomes for patients:

Both the diabetes and cardiovascular disease tools are designed for use by CCGs, while the diabetes tool can also be used by GP practices.

Further supporting materials

To help you use health economic resources and ideas, PHE has developed 2 e-learning modules, which provide an introduction to basic health economics. These modules were developed alongside Health Education England and are hosted on the e-Learning for Healthcare website. Registration is required to access the material, however, it is completely free.

Getting in touch

The Health Economics team is keen to hear feedback on any of the tools and resources that you may have used. If you have any comments, suggestions or questions email

Published 14 May 2017
Last updated 11 October 2019 + show all updates
  1. Removed links to NICE ROI tools.

  2. Updated page with cardiovascular disease resources.

  3. Added 'Contraceptive services: estimating the return on investment' resources.

  4. Added air pollution resources.

  5. Added Prioritisation Framework, plus general editing and restructuring.

  6. Added link to 'Best start in life: cost effective commissioning'.

  7. Added link to fall prevention resources.

  8. Added new links to the musculoskeletal conditions, movement into employment tools and the health economics evidence resource.

  9. Added links to 'Mental health services: cost-effective commissioning' and 'dementia in older age report'.

  10. First published.