Cost-effectiveness analysis of salt reduction policies to reduce coronary heart disease in Syria, 2010–2020

Meredith L. Wilcox, Helen Mason, Fouad M. Fouad, Samer Rastam, Radwan al Ali, Timothy F. Page, Simon Capewell, Martin O’Flaherty, Wasim Maziak

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Objectives This study presents a cost-effectiveness analysis of salt reduction policies to lower coronary heart disease in Syria. Methods Costs and benefits of a health promotion campaign about salt reduction (HP); labeling of salt content on packaged foods (L); reformulation of salt content within packaged foods (R); and combinations of the three were estimated over a 10-year time frame. Policies were deemed cost-effective if their cost-effectiveness ratios were below the region’s established threshold of $38,997 purchasing power parity (PPP). Sensitivity analysis was conducted to account for the uncertainty in the reduction of salt intake. Results HP, L, and R ? HP ? L were cost-saving using the best estimates. The remaining policies were costeffective (CERs: R = $5,453 PPP/LYG; R ? HP = $2,201 PPP/LYG; R ? L = $2,125 PPP/LYG). R ? HP ? L provided the largest benefit with net savings using the best and maximum estimates, while R ? L was cost-effective with the lowest marginal cost using the minimum estimates. Conclusions This study demonstrated that all policies were cost-saving or cost effective, with the combination of reformulation plus labeling and a comprehensive policy involving all three approaches being the most promising salt reduction strategies to reduce CHD mortality in Syria.
Original languageEnglish
Pages (from-to)23-30
Number of pages8
JournalInternational Journal of Public Health
Issue number1
Publication statusPublished - 28 Jun 2014


  • ost Effectiveness
  • coronary heart disease
  • CHD
  • Syria
  • salt reduction


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