An economic evaluation of salt reduction policies to reduce coronary heart disease in England: a policy modeling study

Marissa Collins*, Helen Mason, Martin O'Flaherty, Maria Guzman-Castillo, Julia Critchley, Simon Capewell

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

74 Citations (Scopus)
155 Downloads (Pure)


Dietary salt intake has been causally linked to high blood pressure and increased risk of cardiovascular events. Cardiovascular disease causes approximately 35% of total UK deaths, at an estimated annual cost of £30 billion. The World Health Organization and the National Institute for Health and Care Excellence have recommended a reduction in the intake of salt in people's diets. This study evaluated the cost-effectiveness of four population health policies to reduce dietary salt intake on an English population to prevent coronary heart disease (CHD).

The validated IMPACT CHD model was used to quantify and compare four policies: 1) Change4Life health promotion campaign, 2) front-of-pack traffic light labeling to display salt content, 3) Food Standards Agency working with the food industry to reduce salt (voluntary), and 4) mandatory reformulation to reduce salt in processed foods. The effectiveness of these policies in reducing salt intake, and hence blood pressure, was determined by systematic literature review. The model calculated the reduction in mortality associated with each policy, quantified as life-years gained over 10 years. Policy costs were calculated using evidence from published sources. Health care costs for specific CHD patient groups were estimated. Costs were compared against a “do nothing” baseline.

All policies resulted in a life-year gain over the baseline. Change4life and labeling each gained approximately 1960 life-years, voluntary reformulation 14,560 life-years, and mandatory reformulation 19,320 life-years. Each policy appeared cost saving, with mandatory reformulation offering the largest cost saving, more than £660 million.

All policies to reduce dietary salt intake could gain life-years and reduce health care expenditure on coronary heart disease.
Original languageEnglish
Pages (from-to)517–524
Number of pages8
JournalValue in Health
Issue number5
Early online date31 May 2014
Publication statusPublished - Jul 2014


  • salt reduction
  • heart disease
  • health economics


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