Investing in non-communicable diseases: an estimation of the return on investment for prevention and treatment services

Melanie Y Bertram, Kim Sweeny, Jeremy A Lauer, Daniel Chisholm, Peter Sheehan, Bruce Rasmussen, Senendra Raj Upreti, Lonim Prasai Dixit, Kenneth George, Samuel Deane

Research output: Contribution to journalReview articlepeer-review

53 Citations (Scopus)


The global burden of non-communicable diseases (NCDs) is growing, and there is an urgent need to estimate the costs and benefits of an investment strategy to prevent and control NCDs. Results from an investment-case analysis can provide important new evidence to inform decision making by governments and donors. We propose a methodology for calculating the economic benefits of investing in NCDs during the Sustainable Development Goals (SDGs) era, and we applied this methodology to cardiovascular disease prevention in 20 countries with the highest NCD burden. For a limited set of prevention interventions, we estimated that US$120 billion must be invested in these countries between 2015 and 2030. This investment represents an additional $1·50 per capita per year and would avert 15 million deaths, 8 million incidents of ischaemic heart disease, and 13 million incidents of stroke in the 20 countries. Benefit–cost ratios varied between interventions and country-income levels, with an average ratio of 5·6 for economic returns but a ratio of 10·9 if social returns are included. Investing in cardiovascular disease prevention is integral to achieving SDG target 3.4 (reducing premature mortality from NCDs by a third) and to progress towards SDG target 3.8 (the realisation of universal health coverage). Many countries have implemented cost-effective interventions at low levels, so the potential to achieve these targets and strengthen national income by scaling up these interventions is enormous.

Original languageEnglish
Pages (from-to)2071-2078
Number of pages8
JournalThe Lancet
Issue number10134
Early online date5 Apr 2018
Publication statusPublished - 19 May 2018


  • health coverage
  • cardiovascular disease
  • cost benefit analysis
  • disease control
  • preventive health service
  • non communicable disease


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