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September 2019 (Volume 97)
July 2019 | Brendan Collins, Chris Kypridemos, Jonathan Pearson-Stuttard, Yue Huang, Piotr Bandosz, Parke Wilde, Rogan Kersh, Simon Capewell, Dariush Mozaffarian, Laurie P. Whitsel, Renata Micha, Martin O'Flaherty, on behalf of the Food-PRICE Investigators | Original Scholarship
Context: The US Food and Drug Administration (FDA) set draft voluntary targets to reduce sodium levels in processed foods.We aimed to determine cost effectiveness of meeting these draft sodium targets, from the perspective of US food system workers.
Methods: We employed a microsimulation cost-effectiveness analysis using the US IMPACT Food Policy model with two scenarios: (1) short term, achieving two-year FDA reformulation targets only, and (2) long term, achieving 10-year FDA reformulation targets.We modeled four close-to-reality populations: food system “ever” workers; food system “current” workers in 2017; and subsets of processed food “ever” and “current” workers. Outcomes included cardiovascular disease cases prevented and postponed as well as incremental cost-effectiveness ratio per quality-adjusted life year (QALY) gained from 2017 to 2036.
Findings: Among food system ever workers, achieving long-term sodium reduction targets could produce 20-year health gains of approximately 180,000 QALYs (95% uncertainty interval [UI]: 150,000 to 209,000) and health cost savings of approximately $5.2 billion (95% UI: $3.5 billion to $8.3 billion), with an incremental cost-effectiveness ratio (ICER) of $62,000 (95% UI: $1,000 to $171,000) per QALY gained. For the subset of processed food industry workers, health gains would be approximately 32,000 QALYs (95% UI: 27,000 to 37,000); cost savings, $1.0 billion (95% UI: $0.7bn to $1.6bn); and ICER, $486,000 (95% UI: $148,000 to $1,094,000) per QALY gained. Because many health benefits may occur in individuals older than 65 or the uninsured, these health savings would be shared among individuals, industry, and government.
Conclusions: The benefits of implementing the FDA voluntary sodium targets extend to food companies and food system workers, with the value of health gains and health care cost savings outweighing the costs of reformulation, although not for the processed food industry.
Keywords: cardiovascular disease, cost-effectiveness analysis, food industry, health policy, sodium reduction.
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Published in 2019 Volume 97, Issue 3 (pages 858-880) DOI: 10.1111/1468-0009.12402
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