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Nutrients. 2018 May 14;10(5). pii: E614. doi: 10.3390/nu10050614.

Cost-Effectiveness of Product Reformulation in Response to the Health Star Rating Food Labelling System in Australia.

Author information

1
School of Public Health, Faculty of Medicine, University of Queensland, Brisbane 4001, Australia. ana.mantillaherrera@uqconnect.edu.au.
2
Queensland Centre for Mental Health Research (QCMHR), Wacol 4076, Australia. ana.mantillaherrera@uqconnect.edu.au.
3
The George Institute for Global Health, University of New South Wales, Sydney 2042, Australia. mcrino@georgeinstitute.org.au.
4
School of Public Health, Faculty of Medicine, University of Queensland, Brisbane 4001, Australia. holly_erskine@qcmhr.uq.edu.au.
5
Queensland Centre for Mental Health Research (QCMHR), Wacol 4076, Australia. holly_erskine@qcmhr.uq.edu.au.
6
Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98121, USA. holly_erskine@qcmhr.uq.edu.au.
7
Centre for Clinical Research, University of Queensland, Brisbane 4001, Australia. holly_erskine@qcmhr.uq.edu.au.
8
Global Obesity Centre (GLOBE), Centre for Population Health Research, Deakin University, Geelong 3320, Australia. gary.sacks@deakin.edu.au.
9
Global Obesity Centre (GLOBE), Centre for Population Health Research, Deakin University, Geelong 3320, Australia. jaithri.ananthapavan@deakin.edu.au.
10
Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong 3320, Australia. jaithri.ananthapavan@deakin.edu.au.
11
The George Institute for Global Health, University of New South Wales, Sydney 2042, Australia. c.nimhurchu@auckland.ac.nz.
12
National Institute for Health Innovation, University of Auckland, Auckland 1072, New Zealand. c.nimhurchu@auckland.ac.nz.
13
School of Public Health, Faculty of Medicine, University of Queensland, Brisbane 4001, Australia. y.lee5@uq.edu.au.
14
Queensland Centre for Mental Health Research (QCMHR), Wacol 4076, Australia. y.lee5@uq.edu.au.

Abstract

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]).

KEYWORDS:

Health Star Rating; cost-effectiveness; economic evaluation; front-of-pack labelling; obesity prevention

PMID:
29757979
PMCID:
PMC5986494
DOI:
10.3390/nu10050614
[Indexed for MEDLINE]
Free PMC Article

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