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A Cost Effectiveness Analysis of Salt Reduction Policies to Reduce Coronary Heart Disease in Four Eastern Mediterranean Countries
What is being reported?A cost-effectiveness analysis to investigate policies that could be used to reduce the consumption of salt in Palestine, Syria, Tunisia and Turkey. This was measured in predicted costs of healthcare saved and life years gained (LYG) Where did the data come from and what did they do?The authors used country specific IMPACT CHD models developed as part of the MEDCHAMPs project. These explain past trends in CHD and predict future trends, using standard treatments and major risk factors. Why do this?The burden of coronary heart disease (CHD) is growing quickly in middle income countries and is predicted to have overtaken infectious diseases in all regions bar Subsaharan Africa by 2020. Major CHD risk factors, such as hypertension, high cholesterol and obestity have been increasing as a result of changes in diet and lower levels of physical activity, as well as high rates of tobacco use. The Eastern Mediterannean region is projected to carry the highest burden if current trend continue. What were the results?All policies in all countries gained some life years, however the healthcare cost savings were not always greater than the cost of implementation. In Tunisia, all policies were cost saving apart from health promotion. In Syria and Palestine, the policies involving health promotion and labelling were cost saving. Reformulation of recipes was only cost saving when combined with health promotion and labelling of packaging. In Turkey, all policies were cost saving. When looking at the minimum estimated cost savings, in Tunisia the policies on their own were not cost saving, but combinations of reformulation and health promotion, and reformulation and labelling, as well as all three, were cost saving. In Syria, only labelling was cost saving. In Palestine, health promotion and labelling alone were cost saving, as well as reformulation and health promotion in combination. In Turkey, all policies remained cost saving. What was concluded?"Decreasing dietary salt intake could generate substantial health benefits in terms of life years gained and cost savings."
Salt reduction policies appear to be an effective way of reducing the burden of CHD. In the west, reformulation of processed food to reduce salt has already begun, so the impact of the change in salt level in mass produced imported foods can serve to speed up the process of salt reduction at no extra cost to the home country. Although some policies were not cost saving, they were considered cost effective by the researchers because of the predicted life years gained by implementation. Mason H, Azza Shoaibi A, Rula Ghandour R, Martin O'Flaherty M, Simon Capewell S, Rana Khatib R, Samer Jabr S, Belgin Unal B, Kaan Sözmen K, Chokri Arfa C, Aissi W, Romdhane HB, Fouad F. "A Cost Effectiveness Analysis of Salt Reduction Policies to Reduce Coronary Heart Disease in Four Eastern Mediterranean Countries" PLOS ONE 07 January 2014 |