Cost Effectiveness of Nutrition Policies on Processed Meat: Implications for Cancer Burden in the U.S.

Kim, David D.; Wilde, Parke; Michaud, Dominique S.; Liu, Junxiu; Lizewski, Lauren; Onopa, Jennifer; Mozaffarian, Dariush; Zhang, Fang Fang; Wong, John B.

doi:10.1016/j.amepre.2019.02.023

Cited by 19 publications

(20 citation statements)

References 39 publications

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“…Reducing meat consumption at the population level via taxation may improve public health and mitigate climate change; however, it may also lead to unintended consequences such as changing consumption of other foods that are substitutes for or complements to meat (Nghiem et al, 2013), and impacting rural livelihoods (Bonnet et al, 2020). Most previous studies exploring meat taxes have employed modelling techniques to investigate whether they could improve outcomes such as mortality, environmental costs, and healthcare costs (Broeks et al, 2020;Kim et al, 2019;Sch€ onbach et al, 2019;Springmann et al, 2017;. There is a need to understand societal debates around food from animals using social science approaches (Morris et al, 2021), and interpretive policy analysis can complement quantitative evidence by exploring how language conveys policy meanings (Yanow, 2007).…”

Section: Introduction 11 Backgroundmentioning

confidence: 99%

“It's not as simple as something like sugar”: values and conflict in the UK meat tax debate

Simmonds

Vallgårda

2021

IJHG

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PurposeThis paper qualitatively explores arguments in the UK meat tax debate, including how they align with values from specific political ideologies and perspectives on sustainable food security.Design/methodology/approachThe authors conducted a scoping media analysis of articles published over 1 year in six leading UK newspapers, followed by semi-structured interviews with ten key stakeholders in late 2019. The authors identified categories of arguments, distilled the core conflicts and analysed how arguments reflected different ideas about human nature, the role of the state and solutions to food system challenges.FindingsArguments were categorised into five major topics: climate change and environment; human health; effects on animals; fairness; and acceptability of government intervention. Pro-meat tax arguments often aligned with modern liberal ideology, and sometimes echoed demand restraint or food system transformation perspectives on sustainable food security. Arguments against meat taxes were more likely to align with the efficiency perspective or classical liberal ideology.Originality/valueTo the authors’ knowledge, this is one of the first interpretive analyses of this controversial suggested policy. Despite having similarities with other debates around taxation – particularly taxes on sugar sweetened beverages – the meat tax debate contains unique complexities due to the prominence of environmental arguments, and differing values pertaining to animal welfare and rights. This study highlights the need for policy research exploring values, in addition to quantitative evidence.

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Section: Introduction 11 Backgroundmentioning

confidence: 99%

“It's not as simple as something like sugar”: values and conflict in the UK meat tax debate

Simmonds

Vallgårda

2021

IJHG

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“…The cigarette is also taxed at a much higher rate (nearly half of the pretax price) ( 59 ) than the current SSB tax (about 20% of the pretax price) ( 60 ). Compared with other food tax policies such as 10% excise tax on processed meat ( 21 ), the impact of SSB tax was also smaller, which is likely due to a much larger relative risk estimate of high processed meat ( 24 ) vs high SSB consumption on cancer risk ( 23 , 39 ).…”

Section: Discussionmentioning

confidence: 86%

“…The DiCOM projects the population impact of implementing nutrition policies on health and economic outcomes. Starting from cancer-free individuals representative of the US population, the model simulates the development and progression of cancer as the individuals transition through different health states over a lifetime and tracks life expectancy, cancer-related quality of life, and health-related costs under alternative policy scenarios ( Supplementary Figure 1 , available online) ( 21 ).…”

Section: Methodsmentioning

confidence: 99%

Cost-Effectiveness of a National Sugar-Sweetened Beverage Tax to Reduce Cancer Burdens and Disparities in the United States

Griecci

Kim

et al. 2020

JNCI Cancer Spectrum

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Background Sugar-sweetened beverage (SSB) consumption contributes to obesity, a risk factor for 13 cancers. While SSB taxes can reduce intake, the health and economic impact on reducing cancer burdens in the United States (US) are unknown, especially among low-income Americans with higher SSB intake and obesity-related cancer burdens. Methods We used the Dietary Cancer Outcome Model (DiCOM), a probabilistic cohort state-transition model, to project health gains and economic benefits of a penny-per-ounce national SSB tax on reducing obesity-associated cancers among US adults age 20+ years by income. Results A national SSB tax was estimated to prevent 22,075 (95% uncertainty interval [UI] = 16,040 to 28,577) new cancers cases and 13,524 (95% UI = 9,841 to 17,681) cancer deaths among US adults over a lifetime. The policy was estimated to cost $1.70 (95% UI = $1.50 to $1.95) billion for government implementation and $1.70 (95% UI = $1.48 to $1.96) billion for industry compliance, while saving $2.28 (95% UI = $1.67 to $2.98) billion cancer-related healthcare costs. The SSB tax was highly cost-effective from both a government affordability perspective (incremental cost-effectiveness ratio [ICER] = $1,486, 95% UI = -$3,516 to $9,265 per quality-adjusted life year [QALY]) and a societal perspective (ICER = $13,220, 95% UI = $3,453 to $28,120 per QALY). Approximately 4,800 more cancer cases and 3,100 more cancer deaths would be prevented, and $0.34 billion more healthcare cost savings would be generated among low-income (federal poverty-to-income ratio [FPIR] ≤1.85) than higher-income individuals (FPIR >1.85). Conclusions A penny-per-ounce national SSB tax is cost-effective for cancer prevention in the US, with the largest health gains and economic benefits among lower-income Americans.

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“…We estimated that a ban of minors aged 14 to 17 years with 100% compliance would prevent 15,101 melanoma cases, 3299 melanoma recurrences, and $205.4 million in health care costs over the lifetime of 17.1 million minors in the United States. This is more cost effective than many well‐established public health interventions: processed meats taxation ($270/QALY), 33 smoking education campaign ($1337/QALY), 34 lung cancer screening ($49,200‐$96,700/QALY), 35 cervical cancer screening ($2166/QALY), 36 and breast cancer screening ($29,284/QALY) 37 . The robustness of these findings was supported using a probabilistic sensitivity analysis, which found cost effectiveness was established in the majority of cases.…”

Section: Discussionmentioning

confidence: 99%

To ban or not to ban tanning bed use for minors: A cost‐effectiveness analysis from multiple US perspectives for invasive melanoma

Eskander

Marqueen

Edwards

et al. 2021

Cancer

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Background Tanning bed use is common among US adolescents, but is associated with increased melanoma risk. The decision to ban tanning bed use by adolescents should be made in consideration of the potential health benefits and costs. Methods The US population aged 14 to 17 years was modeled by microsimulation, which compared ban versus no ban strategies. Lifetime quality‐adjusted life years (QALYs) and costs were estimated from a health care sector perspective and two societal perspectives: with and without the costs of policy enforcement and the economic losses of the indoor‐tanning bed industry. Results Full adherence to the ban prevented 15,102 melanoma cases and 3299 recurrences among 17.1 million minors, saving $61in formal and informal health care costs per minor and providing an increase of 0.0002 QALYs. Despite the intervention costs of the ban and the economic losses to the indoor‐tanning industry, banning was still the dominant strategy, with a savings of $12 per minor and $205.4 million among 17.1 million minors. Findings were robust against varying inspection costs and ban compliance, but were sensitive to lower excess risk of melanoma with early exposure to tanning beds. Conclusions A ban on tanning beds for minors potentially lowers costs and increases cost effectiveness. Even after accounting for the costs of implementing a ban, it may be considered cost effective. Even after accounting for the costs of implementing a ban and economic losses in the indoor‐tanning industry, a tanning bed ban for US minors may be considered cost effective. A ban has the potential to reduce the number of melanoma cases while decreasing health care costs. Lay Summary Previous meta‐analyses have linked tanning bed use with an increased risk of melanoma, particularly with initial use at a young age. Yet, it remains unclear whether a ban of adolescents would be cost effective. Overall, a ban has the potential to reduce the number of melanoma cases while promoting a decrease in health care costs. Even after accounting for the costs of implementing a ban and the economic losses incurred by the indoor‐tanning industry, a ban would be cost effective.

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Cost Effectiveness of Nutrition Policies on Processed Meat: Implications for Cancer Burden in the U.S.

Cited by 19 publications

References 39 publications

“It's not as simple as something like sugar”: values and conflict in the UK meat tax debate

“It's not as simple as something like sugar”: values and conflict in the UK meat tax debate

Cost-Effectiveness of a National Sugar-Sweetened Beverage Tax to Reduce Cancer Burdens and Disparities in the United States

To ban or not to ban tanning bed use for minors: A cost‐effectiveness analysis from multiple US perspectives for invasive melanoma

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