Modeled health economic and equity impact on dental caries and health outcomes from a 20% sugar sweetened beverages tax in Australia

Health Econ. 2023 Nov;32(11):2568-2582. doi: 10.1002/hec.4739. Epub 2023 Jul 21.

Abstract

Dental caries is the most prevalent oral disease across the life course. This study modeled the population health and economic impact of a 20% sugar sweetened beverages tax (SSB) for preventing dental caries compared to no intervention (societal and healthcare perspective). A cost-effectiveness analysis according to quintiles of area-level socioeconomic disadvantage was performed for the 2020 Australian population (0-100 years old) using a closed cohort Markov model. A qualitative assessment of implementation considerations (e.g., acceptability, equity, sustainability) was undertaken. Health outcomes were modeled as decayed teeth prevented and disability-adjusted life years (DALYs) averted. The 10-year and lifetime scenarios were modeled with probabilistic sensitivity analysis (Monte Carlo simulation, 2000 cycles). The 10-year scenario from a societal perspective yielded cost-savings of AUD$63.5M, healthcare cost-savings of AUD$42.2M, 510,977 decayed teeth averted and 98.1 DALYs averted. The lifetime scenario resulted in societal cost savings of AUD$176.6M, healthcare cost-savings of AUD$122.5M, 1,309,211 decayed teeth averted and 254.9 DALYs averted. Modeling indicated 71.5% and 74.5% cost-effectiveness for the 10-year and lifetime scenarios, respectively. A three-fold health benefit for the least advantaged was found compared to the most advantaged. A 20% SSB tax in Australia is cost-effective and promotes health equity.

Keywords: cost-effectiveness analysis; dental caries; economic evaluation; public policy; sugar sweetened beverages; taxes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Australia / epidemiology
  • Beverages
  • Child
  • Child, Preschool
  • Dental Caries* / epidemiology
  • Dental Caries* / prevention & control
  • Humans
  • Infant
  • Infant, Newborn
  • Middle Aged
  • Outcome Assessment, Health Care
  • Sugar-Sweetened Beverages*
  • Taxes
  • Young Adult