Cost-Effectiveness of a National Sugar-Sweetened Beverage Tax to Reduce Cancer Burden and Disparities in the United States
Menée à partir d'une modélisation, cette étude estime le rapport coût-efficacité d'une taxe nationale sur les boissons sucrées pour prévenir le risque de cancer associé à l'obésité et réduire les inégalités économiques aux Etats-Unis
Background : Sugar-sweetened beverage (SSB) consumption contributes to obesity, a risk factor for 13 cancers. While SSB taxes can reduce intake, the health and economic impact on reducing cancer burdens in the United States (US) are unknown, especially among low-income Americans with higher SSB intake and obesity-related cancer burdens. Methods : We used the Dietary Cancer Outcome Model (DiCOM), a probabilistic cohort state-transition model, to project health gains and economic benefits of a penny-per-ounce national SSB tax on reducing obesity-associated cancers among US adults age 20+ years by income. Results : A national SSB tax was estimated to prevent 22,075 (95% uncertainty interval [UI] = 16,040 to 28,577) new cancers cases and 13,524 (95% UI = 9,841 to 17,681) cancer deaths among US adults over a lifetime. The policy was estimated to cost $1.70 (95% UI = $1.50 to $1.95) billion for government implementation and $1.70 (95% UI = $1.48 to $1.96) billion for industry compliance, while saving $2.28 (95% UI = $1.67 to $2.98) billion cancer-related healthcare costs. The SSB tax was highly cost-effective from both a government affordability perspective (incremental cost-effectiveness ratio [ICER] = $1,486, 95% UI = -$3,516 to $9,265 per quality-adjusted life year [QALY]) and a societal perspective (ICER = $13,220, 95% UI = $3,453 to $28,120 per QALY). Approximately 4,800 more cancer cases and 3,100 more cancer deaths would be prevented, and $0.34 billion more healthcare cost savings would be generated among low-income (federal poverty-to-income ratio [FPIR] ≤1.85) than higher-income individuals (FPIR >1.85). Conclusions : A penny-per-ounce national SSB tax is cost-effective for cancer prevention in the US, with the largest health gains and economic benefits among lower-income Americans.