Table 2.
Estimated health gains, costs, and cost-effectiveness of a penny-per-ounce national sugar-sweetened beverage (SSB) tax on reducing cancer burden among US adults aged 20 years or older over a lifetimea
| Health gains and cost-effectiveness |
|
|
|
|---|---|---|---|
| Overall health outcomes | |||
| New cancer cases prevented | 22 075 (16 040 to 28 577) | 15 806 (12 888 to 19 020) | 10 965 (7577 to 14 884) |
| Cancer deaths averted | 13 524 (9841 to 17 681) | 9714 (7904 to 11 805) | 6609 (4594 to 9018) |
| Life-years saved | 60 407 (43 089 to 79 594) | 44 768 (36 171 to 54 390) | 31 186 (21 479 to 42 304) |
| QALYs gained | 86 542 (62 220 to 113 147) | 63 277 (51 833 to 76 727) | 44 980 (31 148 to 61 632) |
| Policy implementation costs, $ millionsb | |||
| Government administration costs | 1704 (1502 to 1948) | 670 (586 to 774) | 1000 (880 to 1133) |
| Industry compliance costs | 1695 (1476 to 1955) | 666 (576 to 772) | 994 (871 to 1135) |
| Cancer-related healthcare costs, $ millions | |||
| Direct medical costs | −1586 (-2069 to -1160) | −1092 (-1306 to -914) | −879 (-1209 to -615) |
| Productivity loss costs | −607 (-794 to -435) | −441 (-529 to -364) | −331 (-451 to -266) |
| Patient time costs | −98 (-129 to -69) | −71 (-84 to -58) | −54 (-75 to -36) |
| Net costs, $ millionsc | |||
| Government affordability perspective | 125 (-383 to 605) | −422 (-639 to -223) | 111 (-225 to 421) |
| Societal perspectivec | 1126 (388 to 1814) | −272 (-580 to 28) | 723 (236 to 1145) |
| ICER, $ | |||
| Government affordability perspectiveb | 1486 (-3516 to 9265) | Cost-saving | 2486 (-3733 to 13 458) |
| Societal perspectivec | 13 220 (3453 to 28 120) | Cost-saving | 16 203 (3902 to 36 085) |
Low-income was defined as the federal poverty-to-income ratio (FPIR) ≤ 1.85, and higher-income was defined as FPIR > 1.85. ICER = incremental cost-effectiveness ratio; QALYs = quality-adjusted life years; UI, uncertainty interval.
Policy implementation costs represent the net present value over a lifetime with a 3% discount rate. The tax policy was assumed to have a one-time effect on reducing SSB consumption that lasts for subsequent years with no further reduction.
The government affordability perspective reflects the difference between the government costs for implementing the policy and direct healthcare costs saved for cancer care. The societal perspective reflects the difference between the policy implementation costs (including both government administration costs and industry compliance costs) and the health-related costs saved (including direct healthcare costs, productivity loss costs, and patient time costs).