TY - JOUR
T1 - Cost-effectiveness of product reformulation in response to the health star rating food labelling system in australia
AU - Herrera, Ana Maria Mantilla
AU - Crino, Michelle
AU - Erskine, Holly E.
AU - Sacks, Gary
AU - Ananthapavan, Jaithri
AU - Ni Mhurchu, Cliona
AU - Lee, Yong Yi
N1 - Funding Information:
Acknowledgments: A.M.M.H., M.C., G.S. and J.A. are researchers within the Australian Government National Health and Medical Research Council (NHMRC) Centre for Research Excellence in Obesity Policy and Food Systems (APP1041020). G.S. is the recipient of an Australian Research Council Discovery Early Career Researcher Award (DE160100307). H.E. is the recipient of an NHMRC Early Career Fellowship (APP1137969). The views expressed in this manuscript are solely those of the authors and do not reflect the views of the NHMRC. These funding sources had no role or influence on the study. The authors would like to acknowledge Jazzmin Zheng for assisting with data from the Australian Health Survey data.
Publisher Copyright:
© 2018 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2018/5
Y1 - 2018/5
N2 - The Health Star Rating (HSR) system is a voluntary front-of-pack labelling (FoPL) initiative endorsed by the Australian government in 2014. This study examines the impact of the HSR system on pre-packaged food reformulation measured by changes in energy density between products with and without HSR. The cost-effectiveness of the HSR system was modelled using a proportional multi-state life table Markov model for the 2010 Australian population. We evaluated scenarios in which the HSR system was implemented on a voluntary and mandatory basis (i.e., HSR uptake across 6.7% and 100% of applicable products, respectively). The main outcomes were health-adjusted life years (HALYs), net costs, and incremental cost-effectiveness ratios (ICERs). These were calculated with accompanying 95% uncertainty intervals (95% UI). The model predicted that HSR-attributable reformulation leads to small reductions in mean population energy intake (voluntary: 0.98 kJ/day [95% UI: −1.08 to 2.86]; mandatory: 11.81 kJ/day [95% UI: −11.24 to 36.13]). These are likely to result in reductions in mean body weight (voluntary: 0.01 kg [95% UI: −0.01 to 0.03]; mandatory: 0.11 kg [95% UI: −0.12 to 0.32], and HALYs (voluntary: 4207 HALYs [95% UI: 2438 to 6081]; mandatory: 49,949 HALYs [95% UI: 29,291 to 72,153]). The HSR system evaluated via changes in reformulation could be considered cost-effective relative to a willingness-to-pay threshold of A$50,000 per HALY (voluntary: A$1728 per HALY [95% UI: dominant to 10,445] and mandatory: A$4752 per HALY [95% UI: dominant to 16,236]).
AB - The Health Star Rating (HSR) system is a voluntary front-of-pack labelling (FoPL) initiative endorsed by the Australian government in 2014. This study examines the impact of the HSR system on pre-packaged food reformulation measured by changes in energy density between products with and without HSR. The cost-effectiveness of the HSR system was modelled using a proportional multi-state life table Markov model for the 2010 Australian population. We evaluated scenarios in which the HSR system was implemented on a voluntary and mandatory basis (i.e., HSR uptake across 6.7% and 100% of applicable products, respectively). The main outcomes were health-adjusted life years (HALYs), net costs, and incremental cost-effectiveness ratios (ICERs). These were calculated with accompanying 95% uncertainty intervals (95% UI). The model predicted that HSR-attributable reformulation leads to small reductions in mean population energy intake (voluntary: 0.98 kJ/day [95% UI: −1.08 to 2.86]; mandatory: 11.81 kJ/day [95% UI: −11.24 to 36.13]). These are likely to result in reductions in mean body weight (voluntary: 0.01 kg [95% UI: −0.01 to 0.03]; mandatory: 0.11 kg [95% UI: −0.12 to 0.32], and HALYs (voluntary: 4207 HALYs [95% UI: 2438 to 6081]; mandatory: 49,949 HALYs [95% UI: 29,291 to 72,153]). The HSR system evaluated via changes in reformulation could be considered cost-effective relative to a willingness-to-pay threshold of A$50,000 per HALY (voluntary: A$1728 per HALY [95% UI: dominant to 10,445] and mandatory: A$4752 per HALY [95% UI: dominant to 16,236]).
KW - Cost-effectiveness
KW - Economic evaluation
KW - Front-of-pack labelling
KW - Health Star Rating
KW - Obesity prevention
UR - https://www.scopus.com/pages/publications/85047102824
U2 - 10.3390/nu10050614
DO - 10.3390/nu10050614
M3 - Article
C2 - 29757979
AN - SCOPUS:85047102824
SN - 2072-6643
VL - 10
JO - Nutrients
JF - Nutrients
IS - 5
M1 - 614
ER -
