Epidemiology and Population Health

The potential cost-effectiveness of mandatory restrictions on price promotions for sugar-sweetened beverages in Australia

Abstract

Background

Restricting price promotions on unhealthy foods and beverages has been identified by governments as a promising approach for improving population diets. Using a limited societal perspective, this study assessed the potential cost-effectiveness of mandatory restrictions on price promotions for sugar-sweetened beverages (SSBs) in Australia.

Methods

Australian dietary consumption data, together with UK data on the SSB sales uplift associated with price promotions, were used to estimate reductions in SSB purchases and consequent changes in body mass index following the intervention. A multi-state, multiple-cohort Markov model was used to estimate the obesity-related health and cost impacts over the lifetime of the 2010 Australian population. Costs included passing legislation, assisting retailer implementation, and compliance monitoring.

Results

The intervention was estimated to result in a mean change in daily energy intake of −12.52 kJ (95% Uncertainty Interval, UI: −15.91 to −9.58) per person, which translated to a mean body weight change of −0.11 kg (95%UI: −0.14 to −0.08) per person. Total Health Adjusted Life Years gained were estimated at 34,260 (95%UI: 24,922–45,504). Estimated costs were AUD17.0 million, with estimated healthcare cost savings of AUD376.0 million. The intervention was considered dominant (cost-saving and health promoting). The intervention remained cost-effective if retailers reduced average non-discounted SSB prices in response to the intervention by less than 5.36%.

Conclusions

Restricting price promotions on SSBs is likely to be highly cost-effective, although its impact would depend on how industry and shoppers respond. Although Australian data are used, these results are likely to be transferable and highly relevant to the UK context. Policies for restricting price promotions should be considered as part of a comprehensive obesity prevention strategy.

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Author contributions

All authors contributed to the development of the research question, design of the methods, provided critical feedback on draft versions of this manuscript and have provided final approval for publishing. OH and KB sourced and interpreted the data for this work. OH and JA analysed this data and interpreted the results. All authors agree to be held accountable for all aspects of this research.

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Correspondence to Kathryn Backholer.

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Conflict of interest

All authors have completed the ICMJE uniform disclosure form and declare no support from any organisation for the submitted work. GS, AJC and MM are the academic partners on a healthy supermarket intervention trial that includes Australian local government and supermarket retail (IGA) collaborators. JA, GS, MM, JM, AP, and AJC are part of a NHMRC Centre of Research Excellence in Obesity Policy and Food Systems #1041020. AJC and GS are the recipients of Australian Research Council Discovery Early Career Researcher Awards (project numbers DE160100141 and DE160100307). All other authors have no conflict of interests or funding to declare.

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Huse, O., Ananthapavan, J., Sacks, G. et al. The potential cost-effectiveness of mandatory restrictions on price promotions for sugar-sweetened beverages in Australia. Int J Obes (2019). https://doi.org/10.1038/s41366-019-0495-9

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