The Potential Cost-Effectiveness and Equity Impacts of Restricting Television Advertising of Unhealthy Food and Beverages to Australian Children

Brown, Vicki; Ananthapavan, Jaithri; Veerman, Lennert; Sacks, Gary; Lal, Anita; Peeters, Anna; Backholer, Kathryn; Moodie, Marj

doi:10.3390/nu10050622

Cited by 46 publications

(65 citation statements)

References 33 publications

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“…The three most cost-effective interventions ('Alcohol price increase: uniform volumetric tax' [41], 'Sugar-sweetened beverages tax-20%' [21], and 'Restricting television advertising of unhealthy foods' [45]) were all regulatory interventions. The regulatory interventions appeared higher on the cost-effectiveness league table compared to program-based interventions.…”

Section: Discussionmentioning

confidence: 99%

“…Although we attempted to account for industry impacts in the evaluations, limited data availability meant that the impact on industry revenue resulting from regulatory interventions was not captured in the base case results, potentially underestimating the true cost of regulatory interventions. As part of the evaluation of one intervention ('Restricting television advertising of unhealthy foods' [45]), we conducted sensitivity analyses to include the impact of short term revenue losses to industry (television broadcasters) on cost-effectiveness results, and found that the intervention remained 'dominant'. For another intervention ('Restrictions on price promotions of sugar-sweetened beverages' [46]), we conducted a threshold analysis to determine the level of industry response at which the intervention would no longer be costeffective.…”

Section: Discussionmentioning

confidence: 99%

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Priority-setting for obesity prevention—The Assessing Cost-Effectiveness of obesity prevention policies in Australia (ACE-Obesity Policy) study

et al. 2020

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The aim of the ACE-Obesity Policy study was to assess the economic credentials of a suite of obesity prevention policies across multiple sectors and areas of governance for the Australian setting. The study aimed to place the cost-effectiveness results within a broad decision-making context by providing an assessment of the key considerations for policy implementation. The Assessing Cost-Effectiveness (ACE) approach to priority-setting was used. Systematic literature reviews were undertaken to assess the evidence of intervention effectiveness on body mass index and/or physical activity for selected interventions. A standardised evaluation framework was used to assess the cost-effectiveness of each intervention compared to a 'no intervention' comparator, from a limited societal perspective. A multistate life table Markov cohort model was used to estimate the long-term health impacts (quantified as health adjusted life years (HALYs)) and health care cost-savings resulting from each intervention. In addition to the technical cost-effectiveness results, qualitative assessments of implementation considerations were undertaken. All 16 interventions evaluated were found to be cost-effective (using a willingness-to-pay threshold of AUD50,000 per HALY gained). Eleven interventions were dominant (health promoting and cost-saving). The incremental cost-effectiveness ratio for the non-dominant interventions ranged from AUD1,728 to 28,703 per HALY gained. Regulatory interventions tended to rank higher on their cost-effectiveness results, driven by lower implementation costs. However, the program-based policy interventions were generally based on higher quality evidence of intervention effectiveness. This comparative analysis of the economic credentials of obesity prevention policies for Australia indicates that there are a broad range of policies that are likely to be cost-effective, although policy options vary in strength of evidence for effectiveness, affordability, feasibility, acceptability to stakeholders, equity impact and sustainability.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Priority-setting for obesity prevention—The Assessing Cost-Effectiveness of obesity prevention policies in Australia (ACE-Obesity Policy) study

et al. 2020

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“…Future cost savings and benefits (HALYs) were discounted at 3% per year as per previous cost-effectiveness analyses for prevention interventions in Australia and are presented in 2010 values [5,14,31]. Incident cases of diseases saved were not discounted.…”

Section: Assessment Of Healthcare Cost Savingsmentioning

confidence: 99%

“…Previous studies investigating the health impacts of policies to reduce consumption of discretionary foods have shown that taxes, package size limits and restricting marketing of discretionary foods and drinks would result in considerable health benefits [5][6][7][8][9][10][11][12][13][14][15][16]. These studies have focused either on SSBs or on discretionary foods in general.…”

Section: Introductionmentioning

confidence: 99%

The Modelled Population Obesity-Related Health Benefits of Reducing Consumption of Discretionary Foods in Australia

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Over one third of Australians’ daily energy intake is from discretionary foods and drinks. While many health promotion efforts seek to limit discretionary food intake, the population health impact of reductions in the consumption of different types of discretionary foods (e.g., sugar-sweetened beverages (SSBs), confectionery, sweet biscuits) has not been quantified. This study estimated the potential reductions in body weight, obesity-related disease incidence, and healthcare cost savings associated with consumption of one less serving per week of different discretionary foods. Reductions in the different types of discretionary food were modelled individually to estimate the impact on energy consumption and population body weight by 5-year age and sex groups. It was assumed that one serving of discretionary food each week was replaced with either a serving of fruit or popcorn, and a serving (375 mL) of SSBs was replaced with coffee, tea, or milk. Proportional multi-state multiple-cohort Markov modelling estimated likely resultant health adjusted life years (HALYs) gained and healthcare costs saved over the lifetime of the 2010 Australian population. A reduction of one serving of SSBs (375 mL) had the greatest potential impact in terms of weight reduction, particularly in ages 19–24 years (mean 0.31 kg, 95% UI: 0.23 kg to 0.37 kg) and overall healthcare cost savings of AUD 793.4 million (95% UI: 589.1 M to 976.1 M). A decrease of one serving of sweet biscuits had the second largest potential impact on weight change overall, with healthcare cost savings of $640.7 M (95% CI: $402.6 M to $885.8 M) and the largest potential weight reduction amongst those aged 75 years and over (mean 0.21 kg, 95% UI: 0.14 kg to 0.27 kg). The results demonstrate that small reductions in discretionary food consumption are likely to have substantial health benefits at the population level. Moreover, the study highlights that policy responses to improve population diets may need to be tailored to target different types of foods for different population groups.

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“…The ACE-Obesity Policy model is a multi-state, multiple cohort life table model that simulates the incidence, prevalence, and mortality related to nine obesity related diseases (i.e., type 2 diabetes, hypertensive heart disease, ischemic heart disease, stroke, osteoarthritis of the hip and knee, kidney cancer, colorectal cancer, endometrial cancer, and breast cancer) over the lifetime of the 2010 Australian population. The ACE-Obesity Policy model has been used to evaluate the economic credentials of various obesity policies in Australia [28][29][30][31] and details of the model have been previously published [27,32,33]. In brief, the model uses the prevalence of overweight and obesity taken from the Australian Health Survey 2010 [34] and relative risk estimates from the Global Burden of Disease (GBD) 2010 [35] to calculate the population impact fractions for nine obesity-related diseases.…”

Section: Health Outcomes Modelingmentioning

confidence: 99%

Increasing the Price of Alcohol as an Obesity Prevention Measure: The Potential Cost-Effectiveness of Introducing a Uniform Volumetric Tax and a Minimum Floor Price on Alcohol in Australia

et al. 2020

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The objective of this study was to estimate, from an obesity prevention perspective, the cost-effectiveness of two potential policies that increase the price of alcohol in Australia: a volumetric tax applied to all alcohol (Intervention 1) and a minimum unit floor price (Intervention 2). Estimated changes in alcoholic drink consumption and corresponding changes in energy intake were calculated using the 2011–12 Australian Health Survey data, published price elasticities, and nutrition information. The incremental changes in body mass index (BMI), BMI-related disease outcomes, healthcare costs, and Health Adjusted Life Years (HALYs) were estimated using a validated model. Costs associated with each intervention were estimated for government and industry. Both interventions were estimated to lead to reductions in mean alcohol consumption (Intervention 1: 20.7% (95% Uncertainty Interval (UI): 20.2% to 21.1%); Intervention 2: 9.2% (95% UI: 8.9% to 9.6%)); reductions in mean population body weight (Intervention 1: 0.9 kg (95% UI: 0.84 to 0.96); Intervention 2: 0.45 kg (95% UI: 0.42 to 0.48)); HALYs gained (Intervention 1: 566,648 (95% UI: 497,431 to 647,262); Intervention 2: 317,653 (95% UI: 276,334 to 361,573)); and healthcare cost savings (Intervention 1: $5.8 billion (B) (95% UI: $5.1B to $6.6B); Intervention 2: $3.3B (95% UI: $2.9B to $3.7B)). Intervention costs were estimated as $24M for Intervention 1 and $30M for Intervention 2. Both interventions were dominant, resulting in health gains and cost savings. Increasing the price of alcohol is likely to be cost-effective from an obesity prevention perspective in the Australian context, provided consumers substitute alcoholic beverages with low or no kilojoule alternatives.

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The Potential Cost-Effectiveness and Equity Impacts of Restricting Television Advertising of Unhealthy Food and Beverages to Australian Children

Cited by 46 publications

References 33 publications

Priority-setting for obesity prevention—The Assessing Cost-Effectiveness of obesity prevention policies in Australia (ACE-Obesity Policy) study

Priority-setting for obesity prevention—The Assessing Cost-Effectiveness of obesity prevention policies in Australia (ACE-Obesity Policy) study

The Modelled Population Obesity-Related Health Benefits of Reducing Consumption of Discretionary Foods in Australia

Increasing the Price of Alcohol as an Obesity Prevention Measure: The Potential Cost-Effectiveness of Introducing a Uniform Volumetric Tax and a Minimum Floor Price on Alcohol in Australia

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