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Nutrients 2018, 10(5), 614; https://doi.org/10.3390/nu10050614

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

1
School of Public Health, Faculty of Medicine, University of Queensland, Brisbane 4001, Australia
2
Queensland Centre for Mental Health Research (QCMHR), Wacol 4076, Australia
3
The George Institute for Global Health, University of New South Wales, Sydney 2042, Australia
4
Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98121, USA
5
Centre for Clinical Research, University of Queensland, Brisbane 4001, Australia
6
Global Obesity Centre (GLOBE), Centre for Population Health Research, Deakin University, Geelong 3320, Australia
7
Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong 3320, Australia
8
National Institute for Health Innovation, University of Auckland, Auckland 1072, New Zealand
*
Author to whom correspondence should be addressed.
Received: 5 April 2018 / Revised: 1 May 2018 / Accepted: 10 May 2018 / Published: 14 May 2018
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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]). View Full-Text
Keywords: obesity prevention; cost-effectiveness; economic evaluation; Health Star Rating; front-of-pack labelling obesity prevention; cost-effectiveness; economic evaluation; Health Star Rating; front-of-pack labelling
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Mantilla Herrera, A.M.; Crino, M.; Erskine, H.E.; Sacks, G.; Ananthapavan, J.; Mhurchu, C.N.; Lee, Y.Y. Cost-Effectiveness of Product Reformulation in Response to the Health Star Rating Food Labelling System in Australia. Nutrients 2018, 10, 614.

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