Investing in prevention for men’s health: Increasing NHS Health Check attendance could save the NHS billions

HealthLumen was recently commissioned by Movember, one of the leading charities changing the face of men’s health, to quantify the economic impact of men’s poor health for their ‘Real Face of Men’s Health’ 2024 UK Report.

The study found that in 2023 the five diseases that cause the largest number of years of life lost to ill health for men in the UK – coronary heart disease (CHD), lung cancer, chronic obstructive pulmonary disease (COPD), stroke and colorectal cancer – were estimated to cost £5 billion in direct costs and £10.3 billion in indirect costs. This is equivalent to the annual expenses of more than nine of England’s largest hospitals (1).

The majority of total costs, including both direct and indirect costs, were attributable to cases of preventable disease caused by modifiable risk factors such as physical inactivity, tobacco use, and alcohol consumption. Direct costs associated with these preventable diseases were estimated at £3.4 billion, while indirect costs were estimated at £6.1 billion (Figures 1 and 2).

Figure 1: Direct costs in 2023 due to CHD, lung cancer, colorectal cancer, stroke and COPD in men in the UK

Figure 2: Indirect costs in 2023 due to CHD, lung cancer, colorectal cancer, stroke and COPD in men in the UK

These findings suggest that if all preventable disease cases had been avoided in men, the UK could have saved £9.4 billion in 2023. These results are consistent with existing literature that has found that men are disproportionately affected by avoidable causes of death (2,3) which could largely be avoided through lifestyle behaviour change and earlier diagnosis and treatment (4).

Although avoiding all cases of preventable disease is not realistic, the results of this research indicate that investing in disease prevention methods could have significant economic impacts in the UK.

One such disease prevention scheme is the NHS Health Check program, which invites individuals in England aged between 40 and 75 and without pre-existing health conditions to a free general health check-up every 5 years.

However, only 41% of eligible individuals attend their health check appointments, in contrast to the estimated 75% that was anticipated when NHS Health Checks were first introduced in 2009 (5,6). Moreover, men are disproportionately less likely to attend their health check, with only 38% of invited men attending, compared to 44% of women (5).

A key part of the study was to quantify how an intervention that increases NHS Health Check attendance to 75% across the eligible population could impact the health and economic burden of disease in England from 2024 to 2040, compared to a baseline scenario where health check attendance rates do not change.

To do this, HealthLumen’s microsimulation modelling capability was applied. Results suggest that boosting health check attendance to 75% could avoid 82,000 cases of COPD, 48,000 cases of lung cancer, 27,000 cases of CHD, 10,000 cases of stroke, and 6,000 cases of colorectal cancer in men between 2024 and 2040. Additionally, 85,000 years of working life and 283,000 quality-adjusted life years (QALYs) would be gained by 2040. These intervention impacts were projected to translate into savings of over £1 billion in direct healthcare costs and approximately £1.2 billion in indirect costs between 2024–2040.

The results demonstrate that increasing NHS Health Check attendance could be an effective prevention strategy to reduce both the clinical and economic burden of disease in England, and could dramatically improve men’s quality of life and help to keep more men in the workforce by preventing premature mortality in England.

Such results validate the recent NHS review that recommends improving health check attendance rates as part of the 10-year NHS Long Term Plan published in 2019 (5,7). Possible strategies to increase health check attendance may include scaling up health check awareness campaigns or community health worker outreach to hard-to-reach groups.

In alignment with this, Movember’s UK ‘Real Face of Men’s Health’ Report calls for three “Policy Asks” that will: 1) increase men’s health literacy, 2) transform the UK health system and workforce so that it has capacity to respond to the needs of men, and 3) facilitate research that can bring a better understanding of how men engage with the healthcare system (8). Increasing NHS Health Check attendance to 75% of the eligible population is featured as part of the second Policy Ask.

Such calls for policy change are particularly timely, following the recent general election in the UK, as policy changes are now being set in place for the next five years.

Read Movember’s UK ‘Real Face of Men’s Health’ 2024 Report in full here.

HealthLumen was also commissioned by Movember to conduct an economic analysis on the costs of the five conditions that cause the largest number of years of life lost to ill-health by men in Australia. These conditions were CHD, lung cancer, suicide, COPD and stroke. The research found that the direct and indirect costs totaled AUD$13.9 billion in 2023, with the majority of costs associated with preventable cases of disease.

Read Movember’s Australian ‘Real Face of Men’s Health’ 2024 Report in full here.

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