Modelling the impact of a tax on sweetened beverages in the Philippines: an extended cost–effectiveness analysis

Abstract

ObjectiveTo assess the potential impact of a new tax on sweetened beverages on premature deaths associated with noncommunicable diseases in the Philippines.MethodsIn January 2018, the Philippines began imposing a tax of 6 Philippine pesos per litre (around 13%) on sweetened beverages to curb the obesity burden. Using national data sources, we conducted an extended cost–effectiveness analysis to estimate the effect of the tax on the numbers of premature deaths averted attributed to type 2 diabetes mellitus, ischaemic heart disease and stroke, across income quintiles over the period 2018–2037. We also estimated the financial benefits of the tax from reductions in out-of-pocket payments, direct medical costs averted and government health-care cost savings.FindingsThe tax could avert an estimated 5913 deaths related to diabetes, 10 339 deaths from ischaemic heart disease and 7950 deaths from stroke over 20 years. The largest number of deaths averted could be among the fourth and fifth (highest) income quintiles. The tax could generate total health-care savings of 31.6 billion Philippine pesos (627 million United States dollars, US$) over 20 years, and raise 41.0 billion Philippine pesos (US$ 813 million) in revenue per annum. The poorest quintile could bear the smallest tax burden increase (14% of the additional tax; 5.6 billion Philippine pesos) and have the lowest savings in out-of-pocket payments due to relatively large health-care subsidies. Finally, we estimated that 13 890 cases of catastrophic expenditure could be averted.ConclusionThe new sweetened beverage tax may help to reduce obesity-related premature deaths and improve financial well-being in the Philippines.

The Political Economy of Sugar-Sweetened Beverages Taxation in Latin America: Lessons from Mexico, Chile and Colombia

“…Our ndings concur with tactics used by the tobacco industry and by the food industry in other countries (88). Furthermore, these cases re ect that including several government agencies and strengthening grassroots movements and CSOs, as well as having a multi-sectoral approach to the measure, outlining it in several policy documents, are key elements for scal policies to successfully navigate the health policy process, and has been recognized as a key element for policy success in other case studies (18,89,90).…”

“…In these cases, TNCs were also able to negotiate directly with government regarding policy implementation, successfully subverting policy design so that levels of taxation for SSBs were not aligned with the existing evidence-based recommendations, and some beverages were declared exempt from the tax. In the Philippines, similar tactics were used by TNCs to dilute SSs taxes (Saxena et al 2019). In Colombia, even when advocates managed to raise the topic in public debate, political tactics from the industry opposing SSB taxes were strong enough to prevent it from reaching the policy and legislative agenda.…”

The distributional impact of taxing sugar-sweetened beverages: findings from an extended cost-effectiveness analysis in South Africa

“…To convert changes in BMI into T2DM incidence and associated mortality and model the impact over 20 years, we used a disease incidence model 31–33 48–50. Using data from the Global Burden of Disease study51 on the relative risk (RR) of T2DM due to one-unit increase in BMI (table 2) and the change in age-specific BMI by quintile (calculated above), the age-specific potential impact fraction (PIF) was calculated in the model.…”

Taxes on Sugar-Sweetened Beverages

“…2012;Finkelstein et al 2010;Sharma et al 2014). However, Saxena et al (2019b) predicted that the PHP 6 per liter excise tax on SSBs enacted in the Philippines would avert more deaths in higher-income than lowerincome quintiles. Bourke and Veerman (2018) similarly predicted that a hypothetical US¢30 per liter tax on SSBs in Indonesia would benefit the health of higher-income quintiles significantly more than lowerincome quintiles.…”