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

Helen Mason*, Azza Shoaibi, Rula Ghandour, Martin O'Flaherty, Simon Capewell, Rana Khatib, Samer Jabr, Belgin Unal, Kaan Sozmen, Chokri Arfa, Wafa Aissi, Habiba Ben Romdhane, Fouad Fouad, Radwan Al-Ali, Abdullatif Husseini, MedCHAMPS project team

*Corresponding author for this work

Research output: Contribution to journalArticle

650 Downloads (Pure)

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.
Original languageEnglish
Article numbere84445
JournalPLoS ONE
Volume9
Issue number1
DOIs
Publication statusPublished - 7 Jan 2014

Keywords

  • analysis
  • health economics
  • salt reduction
  • heart disease

Fingerprint Dive into the research topics of 'A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries'. Together they form a unique fingerprint.

  • Profiles

    Cite this

    Mason, H., Shoaibi, A., Ghandour, R., O'Flaherty, M., Capewell, S., Khatib, R., Jabr, S., Unal, B., Sozmen, 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]. https://doi.org/10.1371/journal.pone.0084445