Drug policies should ensure that programmes designed to prevent harm are assessed for their cost-effectiveness by agencies similar to those that assess pharmacological treatments

Programmes and actions designed to promote health and healthy lifestyles, and to prevent health problems and illnesses can improve individual and societal health and well-being, and give a good return on investment. Yet, many current prevention programmes are poorly evaluated or not evaluated at all. Some programmes actually do harm and should be withdrawn. Through mapping and systematic reviews of reviews, there is little evidence to support the majority of prevention approaches currently adopted and delivered by many European countries to address drug problems (Conrod et al., 2015). By contrast, prevention efforts can lead to substantial reductions in drug-related harm when evidence-based programmes are implemented (see Chapter 7). Considerable improvements in health and well-being could be gained from implementing, and only implementing, known evidence-based effective programmes.

Although some countries have bodies that review the impact of prevention and lifestyle programmes (e.g. the National Institute for Health and Care Excellence in the UK, https://www.nice.org.uk/), the existence of such institutions is not consistent or widespread across Europe. In contrast, all countries have mechanisms in place to assess the safety and effectiveness of pharmacological treatments. At the European level, the European Medicines Agency (EMA; http://www.ema.europa.eu/ema/) is responsible for the scientific evaluation of medicines developed by pharmaceutical companies for use in the EU.

Modelled on the EMA, prevention and health promotion programmes could be approved by national agencies or a European Prevention Agency, specifically set up for the purpose, and covering all health topics (Faggiano et al., 2014).

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