Rheumatic fever and rheumatic heart disease : Primary prevention is the cost effective option

Objective. To measure the economic output/input ratios for the various options of prevention of rheumatic fever/rheumatic heart disease (RF/RHD) and check the viability of primary prevention vis-a-vis secondary and tertiary preventions. Methods. Cost accounting of the various prevention options was calculated for each variable as available in literature. Actual data as obtainable for the financial year ending March 2006 were computed for the Pondicherry population. Both direct and indirect costs (including community/social costs) were worked out using mostly primary data, and wherever necessary, secondary data. Certain scientific assumptions were used where exact data was not available. Results. Primary prevention is the definite viable economic option (1:1.56) compared to secondary (1: 1.07) and tertiary (1:0.12) preventions. In fact, the current stress on only secondary and tertiary preventions is found to be economically unviable. Conclusion. It is postulated that primary prevention as a practical policy in tackling RF and RHD can be recommended.