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 ROI
  • compare costs, savings and clinical outcomes

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

Calculating return on investment

ROI tools bring together the best available evidence on costs, savings, and health benefits in a single place. You can use them to estimate the value of investing in early diagnosis and prevention in your area. Each tool looks at a single topic:

In addition to the tools developed by PHE, you may also be interested in the ROI tools produced by the National Institute for Health and Care Excellence (NICE). These include:

  • tobaco
  • alcohol
  • physical activity
  • social wellbeing
  • children, young people and pregnant women

The health economics evidence resources (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 ‘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.

The dementia report was published alongside a number of others, also focusing on dementia. It should be of interest to local authorities and clinical commissioning groups (CCGs).

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 information

For any questions about health economics and return on investment in public health, email

Published 14 May 2017
Last updated 8 March 2018 + show all updates
  1. Added link to 'Best start in life: cost effective commissioning'.
  2. Added link to fall prevention resources.
  3. Added new links to the musculoskeletal conditions, movement into employment tools and the health economics evidence resource.
  4. Added links to 'Mental health services: cost-effective commissioning' and 'dementia in older age report'.
  5. First published.