The Economic Impact of Dietary Sodium Reduction In Canada

Abstract

OBJECTIVES:To determine the cost-utility of dietary sodium reduction in the Canadian population, given on the anticipated effect on incident cardiovascular disease (CVD). METHODS:The Canadian Cardiovascular Disease Policy Model is a state transition model, which simulates CVD events, healthcare costs and consequences from the perspective of a publically funded healthcare system for the Canadian population. We evaluated the economic impact of reducing the dietary sodium intake of Canadian adults. RESULTS:Over a 50-year time horizon, reducing dietary sodium by 1800 mg/day is projected to reduce the cumulative incidence of coronary heart disease and stroke by 2.66% and 4.45% respectively, while decreasing the total number of myocardial infarctions and strokes by 2.23% and 4.45% respectively. The model predicted a decrease in overall mortality of 0.47%, a gain of 1.22 million QALYs, and a savings of $20.7 billion in healthcare costs. CONCLUSION:Reducing dietary sodium intake at the population level has the potenital to substantially decrease healthcare costs and improve health outcomes.

The potential health impact and healthcare cost savings of different sodium reduction strategies in Canada

“…Our results demonstrate that reducing sodium intakes through population-level strategies, such as implementing sodium reduction targets and 'high in' FOPL regulations, has the potential to improve health outcomes and reduce healthcare expenditures in Canada. This adds to current evidence, generated by simulation modeling studies, showing that sodium reduction strategies can potentially improve health outcomes and save costs to the health system, globally (29,(56)(57)(58)(59)(60)(61)(62) and in Canada (10,19).…”

“…We followed the perspective of the public healthcare system; hence, the costs of implementing the sodium reduction interventions were not considered. Although population-wide sodium reduction interventions in Canada were estimated to cost CAD$2.02 per person annually (Canadian population in 2019: 38 million approximately), these costs would be minimal in comparison with savings in healthcare costs (19,68). These costs included government led industry agreements to reduce sodium in packaged foods, government monitoring of industry compliance, and public health campaigns (19,68).…”

“…Although population-wide sodium reduction interventions in Canada were estimated to cost CAD$2.02 per person annually (Canadian population in 2019: 38 million approximately), these costs would be minimal in comparison with savings in healthcare costs (19,68). These costs included government led industry agreements to reduce sodium in packaged foods, government monitoring of industry compliance, and public health campaigns (19,68). We also did not consider societal gains in our modeling, such as productivity gains from preventing premature deaths or disease burden.…”

“…A systematic review of previous policy scenario modeling studies have demonstrated the costeffectiveness of reducing dietary sodium intake (18). Studies in the Canadian context have estimated the economic and health impact of reducing sodium intake to recommended levels when compared to previous sodium intake levels (i.e., 3,800 mg/day) using data from CCHS-Nutrition 2004 (19). More recently, using data from CCHS-Nutrition 2015, we previously estimated the number of CVDs deaths that could be averted or delayed if Canadians were to reduce their sodium intake to recommended levels (10,19), and as a result of implementing 'high in' FOPL regulations (20,21).…”

“…Studies in the Canadian context have estimated the economic and health impact of reducing sodium intake to recommended levels when compared to previous sodium intake levels (i.e., 3,800 mg/day) using data from CCHS-Nutrition 2004 (19). More recently, using data from CCHS-Nutrition 2015, we previously estimated the number of CVDs deaths that could be averted or delayed if Canadians were to reduce their sodium intake to recommended levels (10,19), and as a result of implementing 'high in' FOPL regulations (20,21). However, to the best of our knowledge, no study in Canada has previously estimated the health impact and healthcare cost savings from 'real world' policy scenario options to reduce population level dietary sodium intakes (i.e., food reformulation and mandatory 'high in' FOPL symbol).…”