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

• Published in: International journal of public health Vol. 60; no. Suppl 1; pp. 23 - 30
• Main Authors: Wilcox, Meredith L., Mason, Helen, Fouad, Fouad M., Rastam, Samer, Ali, Radwan al, Page, Timothy F., Capewell, Simon, O’Flaherty, Martin, Maziak, Wasim
• Format: Journal Article
• Language: English
• Published: Basel Springer Basel 01.01.2015; Springer Nature B.V
• Subjects: Cardiovascular disease; Coronary Disease - prevention & control; Coronary vessels; Cost-Benefit Analysis; Environmental Health; Food Labeling; Health Promotion - economics; Health Promotion - methods; Humans; Medicine; Medicine & Public Health; Occupational Medicine/Industrial Medicine; Original Paper; Policy; Public Health; Quality-Adjusted Life Years; Salt; Sodium, Dietary - administration & dosage; Syria; Syria; Salt reduction; Eastern Mediterranean Region; EMR; Cost-effectiveness; Coronary heart disease; CHD; Syria
• DOI: 10.1007/s00038-014-0577-3
• ISSN: 1661-8556

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 cost-effective (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.