Structured assessment of prevention to enable investment decisions in the Netherlands

Abstract In the Netherlands, investments in prevention face stricter criteria than other investments in health. They are often required to demonstrate a positive budgetary impact, rather than a positive net benefit that includes all societal costs and benefits. Following a 2024 advisory report that highlighted problems and solutions regarding investment decisions in preventive interventions, Dutch Government commissioned RIVM to develop an assessment framework to facilitate structured and consistent investment decisions in prevention. The assessment framework should take a broad scope while evaluating investment decisions, including costs and benefits for all actors involved in the specific type of prevention, attention to both monetary and non-monetary costs and benefits, distributional budgetary impact, and other relevant criteria such as impact of prevention on manpower planning. An initial version of the framework, consisting of 8 core elements, will be part of a national and international consultation effort in 2026. Furthermore, this initial version of the framework is applied to “use cases”, i.e. possible preventive investments, such as in school based mental health programs and skin cancer screening via an app. By applying the framework to a diverse range of use cases, we will learn about the feasibility of collecting and producing reliable evidence for each of the 8 core elements. In this talk, the audience will be informed about these ongoing developments in the Netherlands, results of the consultation and the application of the initial framework to use cases.