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

Mason, H; Shoaibi, A; Ghandour, R; O'Flaherty, M; Capewell, S; Khatib, R; Jabr, S; Unal, B; Sözmen, K; Arfa, C; et al. Mason, H; Shoaibi, A; Ghandour, R; O'Flaherty, M; Capewell, S; Khatib, R; Jabr, S; Unal, B; Sözmen, K; Arfa, C; Aissi, W; Ben Romdhane, H; Fouad, F; Al-Ali, R; Husseini, A; MedCHAMPS project team (2014) A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries. PLoS One, 9 (1). e84445. ISSN 1932-6203 https://doi.org/10.1371/journal.pone.0084445
SGUL Authors: Critchley, Julia

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Abstract

BACKGROUND: 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. METHODS AND FINDINGS: 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. CONCLUSION: 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.

Item Type: Article
Additional Information: Copyright: © 2014 Mason et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: Coronary Disease, Cost-Benefit Analysis, Health Promotion, Humans, Middle East, Quality-Adjusted Life Years, Sodium Chloride, Dietary, Syria, Tunisia, Turkey, MedCHAMPS project team, Humans, Coronary Disease, Sodium Chloride, Dietary, Quality-Adjusted Life Years, Health Promotion, Cost-Benefit Analysis, Tunisia, Middle East, Syria, Turkey, MD Multidisciplinary, General Science & Technology
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: PLoS One
ISSN: 1932-6203
Language: eng
Dates:
DateEvent
7 January 2014Published
15 November 2013Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
223075Seventh Framework Programmehttp://dx.doi.org/10.13039/501100004963
PubMed ID: 24409297
Web of Science ID: WOS:000329463500021
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/111726
Publisher's version: https://doi.org/10.1371/journal.pone.0084445

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