Financial incentives for health interventions gain more support

A government-backed think-tank has added its weight to the debate around financial incentives and health interventions, arguing it makes sense to link cash payouts to disease prevention and health promotion policies.

Health England, a cross-departmental group set up by the Department of Health in 2007 to identify interventions that could improve health and wellbeing, has argued that using financial incentives to encourage people to undertake healthy activities can be effective.

Its research, carried out by academics at the London School of Economics, has also concluded that contrary to popular wisdom, taxes on unhealthy behaviours do work, as people consume less alcohol and tobacco when prices are raised.

In a separate study, medics at Kings College London have reached a similar conclusion, arguing in the BMJ that paying people to change their behaviour can work, at least in the short term.

The LSE study argued that one way of encouraging spending on disease prevention programmes would be to reduce their relative cost by using central government funds to provide matching grants.

For example, every £1 spent on specific preventive programmes could be matched with £1 from the centre, in the process reducing the costs of these programmes relative to other demands on Primary Care Trust resources.

Professor Julian Le Grand, co-author of the report and chair of Health England, said: “Policies have to be developed that either bring some of the costs from unhealthy activities – or the benefits from healthy ones – ‘back from the future’. Equally we need to reduce some of the benefits from unhealthy activities – or reduce the costs of healthy ones – in the present.”

The BMJ study, meanwhile, suggested that schemes targeting habitual behaviours such as smoking or physical inactivity in high income countries could be more effective if they provided incentives for initial as well as sustained behaviour change.

By contrast, for schemes aimed at initiating relatively simple behaviours in low income populations, such as clinic attendance and participation in vaccination programmes, small incentives delivered immediately seem most effective.

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