Cardiovascular disease and impoverishment averted due to a salt reduction policy in South Africa

An extended cost-effectiveness analysis

Datos Bibliográficos

ID11490569
AutoresDavid Watkins (0000-0002-3930-5990, Groote Schuur Hospital, autor de correspondencia), David A Watkins, Zachary D Olson, Zachary Olson (0000-0002-6985-8764, Berkeley Public Health Division), Stéphane Verguet (0000-0003-4128-0849, Harvard Global Health Institute), Rachel A Nugent, Rachel Nugent (0000-0001-6421-9077, University of Washington), D T Jamison (0000-0003-4387-6064, Global Brain Health Institute)
Año2016
Volumen31
Número1
Páginas75-82
Fecha de publicación2016-02-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaHealth Policy and Planning (JOURNAL)
Identificadores de la revistaISSN: 0268-1080 • E-ISSN: 1460-2237
EditorialOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czv023
PMID25841771
OpenAlexW2129472020
IdiomaEN
Citas recibidas9
Referencias citadas24

The South African Government recently set targets to reduce cardiovascular disease (CVD) by lowering salt consumption. We conducted an extended cost-effectiveness analysis (ECEA) to model the potential health and economic impacts of this salt policy. We used surveys and epidemiologic studies to estimate reductions in CVD resulting from lower salt intake. We calculated the average out-of-pocket (OOP) cost of CVD care, using facility fee schedules and drug prices. We estimated the reduction in OOP expenditures and government subsidies due to the policy. We estimated public and private sector costs of policy implementation. We estimated financial risk protection (FRP) from the policy as (1) cases of catastrophic health expenditure (CHE) averted or (2) cases of poverty averted. We also performed a sensitivity analysis. We found that the salt policy could reduce CVD deaths by 11%, with similar health gains across income quintiles. The policy could save households US$ 4.06 million (2012) in OOP expenditures (US$ 0.29 per capita) and save the government US$ 51.25 million in healthcare subsidies (US$ 2.52 per capita) each year. The cost to the government would be only US$ 0.01 per capita; hence, the policy would be cost saving. If the private sector food reformulation costs were passed on to consumers, food expenditures would increase by <0.2% across all income quintiles. Preventing CVD could avert 2400 cases of CHE or 2000 cases of poverty yearly. Our results were sensitive to baseline CVD mortality rates and the cost of treatment. We conclude that, in addition to health gains, population salt reduction can have positive economic impacts-substantially reducing OOP expenditures and providing FRP, particularly for the middle class. The policy could also provide large government savings on health care.

Business · Consumption (sociology) · Economic growth · Economics · Environmental health · Government (linguistics) · Health care · Per capita · Per capita income · Population · Poverty · Private sector · Subsidy · Child Nutrition and Water Access · Global Health Care Issues · Medicine · Obesity, Physical Activity, Diet · Health Policy