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Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: a cost-effectiveness and equity analysis

Lal, Anita, Mantilla-Herrera, Ana Maria, Veerman, Lennert, Backholer, Kathryn, Sacks, Gary, Moodie, Marjory, Siahpush, Mohammad, Carter, Robert and Peeters, Anna 2017, Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: a cost-effectiveness and equity analysis, PLoS medicine, vol. 14, no. 6, pp. 1-17, doi: 10.1371/journal.pmed.1002326.

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Title Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: a cost-effectiveness and equity analysis
Author(s) Lal, AnitaORCID iD for Lal, Anita orcid.org/0000-0001-6921-6617
Mantilla-Herrera, Ana Maria
Veerman, Lennert
Backholer, Kathryn
Sacks, GaryORCID iD for Sacks, Gary orcid.org/0000-0001-9736-1539
Moodie, MarjoryORCID iD for Moodie, Marjory orcid.org/0000-0001-6890-5250
Siahpush, Mohammad
Carter, RobertORCID iD for Carter, Robert orcid.org/0000-0002-1586-5619
Peeters, AnnaORCID iD for Peeters, Anna orcid.org/0000-0003-4340-9132
Journal name PLoS medicine
Volume number 14
Issue number 6
Article ID e1002326
Start page 1
End page 17
Total pages 17
Publisher PLoS
Place of publication San Francisco, Calif.
Publication date 2017-06
ISSN 1549-1676
Keyword(s) Australia
Beverages
Cost Savings
Cost-Benefit Analysis
Health Expenditures
Humans
Life Expectancy
Models, Theoretical
Quality-Adjusted Life Years
Sweetening Agents
Taxes
Summary BACKGROUND: A sugar-sweetened beverage (SSB) tax in Mexico has been effective in reducing consumption of SSBs, with larger decreases for low-income households. The health and financial effects across socioeconomic groups are important considerations for policy-makers. From a societal perspective, we assessed the potential cost-effectiveness, health gains, and financial impacts by socioeconomic position (SEP) of a 20% SSB tax for Australia.

METHODS AND FINDINGS: Australia-specific price elasticities were used to predict decreases in SSB consumption for each Socio-Economic Indexes for Areas (SEIFA) quintile. Changes in body mass index (BMI) were based on SSB consumption, BMI from the Australian Health Survey 2011-12, and energy balance equations. Markov cohort models were used to estimate the health impact for the Australian population, taking into account obesity-related diseases. Health-adjusted life years (HALYs) gained, healthcare costs saved, and out-of-pocket costs were estimated for each SEIFA quintile. Loss of economic welfare was calculated as the amount of deadweight loss in excess of taxation revenue. A 20% SSB tax would lead to HALY gains of 175,300 (95% CI: 68,700; 277,800) and healthcare cost savings of AU$1,733 million (m) (95% CI: $650m; $2,744m) over the lifetime of the population, with 49.5% of the total health gains accruing to the 2 lowest quintiles. We estimated the increase in annual expenditure on SSBs to be AU$35.40/capita (0.54% of expenditure on food and non-alcoholic drinks) in the lowest SEIFA quintile, a difference of AU$3.80/capita (0.32%) compared to the highest quintile. Annual tax revenue was estimated at AU$642.9m (95% CI: $348.2m; $1,117.2m). The main limitations of this study, as with all simulation models, is that the results represent only the best estimate of a potential effect in the absence of stronger direct evidence.

CONCLUSIONS: This study demonstrates that from a 20% tax on SSBs, the most HALYs gained and healthcare costs saved would accrue to the most disadvantaged quintiles in Australia. Whilst those in more disadvantaged areas would pay more SSB tax, the difference between areas is small. The equity of the tax could be further improved if the tax revenue were used to fund initiatives benefiting those with greater disadvantage.
Language eng
DOI 10.1371/journal.pmed.1002326
Field of Research 11 Medical And Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2017, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30097739

Document type: Journal Article
Collections: School of Health and Social Development
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.