A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries.

<h4>Background</h4>Coronary Heart Disease (CHD) is rising in middle income countries. Population based strategies to reduce specific CHD risk factors have an important role to play in reducing overall CHD mortality. Reducing dietary salt consumption is a potentially cost-effective way to...

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Autores principales: Helen Mason, Azza Shoaibi, Rula Ghandour, Martin O'Flaherty, Simon Capewell, Rana Khatib, Samer Jabr, Belgin Unal, Kaan Sözmen, Chokri Arfa, Wafa Aissi, Habiba Ben Romdhane, Fouad Fouad, Radwan Al-Ali, Abdullatif Husseini, MedCHAMPS project team
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Publicado: Public Library of Science (PLoS) 2014
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spelling oai:doaj.org-article:3c1dc56cc95a4d82badbabe76365404b2021-11-18T08:38:46ZA cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries.1932-620310.1371/journal.pone.0084445https://doaj.org/article/3c1dc56cc95a4d82badbabe76365404b2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24409297/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Coronary Heart Disease (CHD) is rising in middle income countries. Population based strategies to reduce specific CHD risk factors have an important role to play in reducing overall CHD mortality. Reducing dietary salt consumption is a potentially cost-effective way to reduce CHD events. This paper presents an economic evaluation of population based salt reduction policies in Tunisia, Syria, Palestine and Turkey.<h4>Methods and findings</h4>Three policies to reduce dietary salt intake were evaluated: a health promotion campaign, labelling of food packaging and mandatory reformulation of salt content in processed food. These were evaluated separately and in combination. Estimates of the effectiveness of salt reduction on blood pressure were based on a literature review. The reduction in mortality was estimated using the IMPACT CHD model specific to that country. Cumulative population health effects were quantified as life years gained (LYG) over a 10 year time frame. The costs of each policy were estimated using evidence from comparable policies and expert opinion including public sector costs and costs to the food industry. Health care costs associated with CHDs were estimated using standardized unit costs. The total cost of implementing each policy was compared against the current baseline (no policy). All costs were calculated using 2010 PPP exchange rates. In all four countries most policies were cost saving compared with the baseline. The combination of all three policies (reducing salt consumption by 30%) resulted in estimated cost savings of $235,000,000 and 6455 LYG in Tunisia; $39,000,000 and 31674 LYG in Syria; $6,000,000 and 2682 LYG in Palestine and $1,3000,000,000 and 378439 LYG in Turkey.<h4>Conclusion</h4>Decreasing dietary salt intake will reduce coronary heart disease deaths in the four countries. A comprehensive strategy of health education and food industry actions to label and reduce salt content would save both money and lives.Helen MasonAzza ShoaibiRula GhandourMartin O'FlahertySimon CapewellRana KhatibSamer JabrBelgin UnalKaan SözmenChokri ArfaWafa AissiHabiba Ben RomdhaneFouad FouadRadwan Al-AliAbdullatif HusseiniMedCHAMPS project teamPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 1, p e84445 (2014)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Helen Mason
Azza Shoaibi
Rula Ghandour
Martin O'Flaherty
Simon Capewell
Rana Khatib
Samer Jabr
Belgin Unal
Kaan Sözmen
Chokri Arfa
Wafa Aissi
Habiba Ben Romdhane
Fouad Fouad
Radwan Al-Ali
Abdullatif Husseini
MedCHAMPS project team
A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries.
description <h4>Background</h4>Coronary Heart Disease (CHD) is rising in middle income countries. Population based strategies to reduce specific CHD risk factors have an important role to play in reducing overall CHD mortality. Reducing dietary salt consumption is a potentially cost-effective way to reduce CHD events. This paper presents an economic evaluation of population based salt reduction policies in Tunisia, Syria, Palestine and Turkey.<h4>Methods and findings</h4>Three policies to reduce dietary salt intake were evaluated: a health promotion campaign, labelling of food packaging and mandatory reformulation of salt content in processed food. These were evaluated separately and in combination. Estimates of the effectiveness of salt reduction on blood pressure were based on a literature review. The reduction in mortality was estimated using the IMPACT CHD model specific to that country. Cumulative population health effects were quantified as life years gained (LYG) over a 10 year time frame. The costs of each policy were estimated using evidence from comparable policies and expert opinion including public sector costs and costs to the food industry. Health care costs associated with CHDs were estimated using standardized unit costs. The total cost of implementing each policy was compared against the current baseline (no policy). All costs were calculated using 2010 PPP exchange rates. In all four countries most policies were cost saving compared with the baseline. The combination of all three policies (reducing salt consumption by 30%) resulted in estimated cost savings of $235,000,000 and 6455 LYG in Tunisia; $39,000,000 and 31674 LYG in Syria; $6,000,000 and 2682 LYG in Palestine and $1,3000,000,000 and 378439 LYG in Turkey.<h4>Conclusion</h4>Decreasing dietary salt intake will reduce coronary heart disease deaths in the four countries. A comprehensive strategy of health education and food industry actions to label and reduce salt content would save both money and lives.
format article
author Helen Mason
Azza Shoaibi
Rula Ghandour
Martin O'Flaherty
Simon Capewell
Rana Khatib
Samer Jabr
Belgin Unal
Kaan Sözmen
Chokri Arfa
Wafa Aissi
Habiba Ben Romdhane
Fouad Fouad
Radwan Al-Ali
Abdullatif Husseini
MedCHAMPS project team
author_facet Helen Mason
Azza Shoaibi
Rula Ghandour
Martin O'Flaherty
Simon Capewell
Rana Khatib
Samer Jabr
Belgin Unal
Kaan Sözmen
Chokri Arfa
Wafa Aissi
Habiba Ben Romdhane
Fouad Fouad
Radwan Al-Ali
Abdullatif Husseini
MedCHAMPS project team
author_sort Helen Mason
title A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries.
title_short A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries.
title_full A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries.
title_fullStr A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries.
title_full_unstemmed A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries.
title_sort cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four eastern mediterranean countries.
publisher Public Library of Science (PLoS)
publishDate 2014
url https://doaj.org/article/3c1dc56cc95a4d82badbabe76365404b
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