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There’s growing global interest in investing in disease prevention—not just to improve health but to cut health care costs. The idea seems simple: if people eat better, exercise more, and make healthier lifestyle choices, then their medical expenses should decrease. But there’s a problem with this well-intentioned thinking. If prevention is expected both to improve health and to save money, while traditional treatments are only expected to improve health (at a price), then prevention is being held to a much tougher standard—one it may not be able to meet. When a new treatment is introduced, the key question is whether it improves health by being safe and effective. The next question is whether the treatment is worth the cost. Does the health benefit justify the price? It’s an uncomfortable calculation, but in a world of limited resources, it’s necessary.