دورية أكاديمية
Estimating the health and economic effects of the proposed US Food and Drug Administration voluntary sodium reformulation: Microsimulation cost-effectiveness analysis.
| العنوان: | Estimating the health and economic effects of the proposed US Food and Drug Administration voluntary sodium reformulation: Microsimulation cost-effectiveness analysis. |
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| المؤلفون: | Jonathan Pearson-Stuttard, Chris Kypridemos, Brendan Collins, Dariush Mozaffarian, Yue Huang, Piotr Bandosz, Simon Capewell, Laurie Whitsel, Parke Wilde, Martin O'Flaherty, Renata Micha |
| المصدر: | PLoS Medicine, Vol 15, Iss 4, p e1002551 (2018) |
| بيانات النشر: | Public Library of Science (PLoS), 2018. |
| سنة النشر: | 2018 |
| المجموعة: | LCC:Medicine |
| مصطلحات موضوعية: | Medicine |
| الوصف: | BackgroundSodium consumption is a modifiable risk factor for higher blood pressure (BP) and cardiovascular disease (CVD). The US Food and Drug Administration (FDA) has proposed voluntary sodium reduction goals targeting processed and commercially prepared foods. We aimed to quantify the potential health and economic impact of this policy.Methods and findingsWe used a microsimulation approach of a close-to-reality synthetic population (US IMPACT Food Policy Model) to estimate CVD deaths and cases prevented or postponed, quality-adjusted life years (QALYs), and cost-effectiveness from 2017 to 2036 of 3 scenarios: (1) optimal, 100% compliance with 10-year reformulation targets; (2) modest, 50% compliance with 10-year reformulation targets; and (3) pessimistic, 100% compliance with 2-year reformulation targets, but with no further progress. We used the National Health and Nutrition Examination Survey and high-quality meta-analyses to inform model inputs. Costs included government costs to administer and monitor the policy, industry reformulation costs, and CVD-related healthcare, productivity, and informal care costs. Between 2017 and 2036, the optimal reformulation scenario achieving the FDA sodium reduction targets could prevent approximately 450,000 CVD cases (95% uncertainty interval: 240,000 to 740,000), gain approximately 2.1 million discounted QALYs (1.7 million to 2.4 million), and produce discounted cost savings (health savings minus policy costs) of approximately $41 billion ($14 billion to $81 billion). In the modest and pessimistic scenarios, health gains would be 1.1 million and 0.7 million QALYS, with savings of $19 billion and $12 billion, respectively. All the scenarios were estimated with more than 80% probability to be cost-effective (incremental cost/QALY < $100,000) by 2021 and to become cost-saving by 2031. Limitations include evaluating only diseases mediated through BP, while decreasing sodium consumption could have beneficial effects upon other health burdens such as gastric cancer. Further, the effect estimates in the model are based on interventional and prospective observational studies. They are therefore subject to biases and confounding that may have influenced also our model estimates.ConclusionsImplementing and achieving the FDA sodium reformulation targets could generate substantial health gains and net cost savings. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 1549-1277 1549-1676 |
| Relation: | https://doaj.org/toc/1549-1277; https://doaj.org/toc/1549-1676 |
| DOI: | 10.1371/journal.pmed.1002551 |
| URL الوصول: | https://doaj.org/article/65a1030af3ae41eda9581688d5aa7674 |
| رقم الأكسشن: | edsdoj.65a1030af3ae41eda9581688d5aa7674 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 15491277 15491676 |
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| DOI: | 10.1371/journal.pmed.1002551 |