January 1, 2019
Learn how governments can implement cost-effective and cost-saving policy measures to increase healthy eating
Inside this healthy eating policy pack
What economic evidence exists in support of healthy eating policy approaches?
A 2018 rapid synthesis of economic evidence in support of population-level policy approaches for healthy eating provided the following evidence:1
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| Mandatory labelling and traffic-light labelling are generally cost-effective or cost-saving interventions to improve the consumption of healthy foods across a variety of country contexts |
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- A recent OECD report estimated the cost-effectiveness ratio of implementing food labelling interventions in Canada falls below $50,000 USD per DALY 10 years following implementation
- A medium-quality review found the adoption of mandatory labelling was cost effective with an ICER of $5,282 USD per DALY, and cost-saving in Australia and Mexico
- A primary study found implementing traffic-light labelling was cost-effective and cost-saving in Australia, with a cost-effectiveness ratio of $1,800 AUD per DALY averted
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| Adjusting the price of food is cost-effective to incentivize healthy eating, however, literature notes that the effectiveness of tax interventions are dependent on a variety of factors |
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- A high-quality review found fiscal measures (including taxation of unhealthy foods or subsidies for healthy foods) had a probability of 100% being cost-effective and cost-saving in Australia, the UK and Mexico
- A primary study found implementation of a 10% junk food tax to be cost-effective and cost-saving with a cost-effectiveness ratio of $30 AUD per DALY averted
- A review and two primary studies suggest subsidies for healthy foods tend to be more effective and cost-effective in promoting healthy eating than use of taxes, especially for low income consumers
- A medium-quality review indicated a fruit and vegetable subsidy that reduced price by 1% predicted a reduction of 6,733 cases of coronary heart disease and 2,946 cases of ischemic stroke in the US, at an average cost of $1.29M USD per life saved
- A primary study found expansion of a 30% rebate on healthy foods purchased using food stamps was cost-effective with an ICER of $16,172 USD per QALY gained
- A primary study comparing information campaigns and price interventions found the cost-to-life-years-saved ratio to be lowest for information campaign (3,000 EUR), followed by value-added tax reduction (99,000 EUR) and food stamp vouchers (403,000 EUR). Taxes were found to increase health inequalities, while food stamps were found to reduce health inequalities.
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| Reducing sodium in processed foods by establishing thresholds is a cost-effective intervention |
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- A low-quality review found that regulation of sodium content in foods is consistently cost-effective and cost-saving across country contexts
- A primary study found that reductions in sodium intake set at 1840mg/day would reduce blood pressure by 5/2mm Hg to manage hypertension, reduce annual health spending for hypertension in Canada by up to $430M/year, and an additional cost-savings of $108M/year via reduced spending on physician and lab services
- A primary study estimated that reducing sodium intake by 1.0g per day, and replacing 1 energy per cent of saturated fat with polyunsaturated fat could significantly reduce rates of cardiovascular disease in Finland, and was cost-saving of up to 225M EUR
- A primary study found a reduction in sodium increased QALYs by 1.3M and saved $32.1B USD in medical costs over the lifetime of US adults aged 40-85
- A primary study found setting mandatory 35% reduction in sodium content in all packaged foods, fast foods, and restaurant meals would result in a net gain of 235,000 QALYs
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| Evidence suggests workplace health promotion programs integrating diet and physical activity interventions (e.g., healthier food available at workplace canteens or vending machines) are likely cost-effective. |
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- A medium quality review indicated these workplace programs result in weight reduction, with a range of cost-effectiveness between $1.44 and $4.16 per pound of body weight loss
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References
1 Waddell K, Wilson MG, Panchal P, Mattison CA. Rapid synthesis: Identifying effective and cost-effective population-level approaches to promote healthy eating. Hamilton: McMaster Health Forum, 29 March 2018.
