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. 2018 May 14;10(5):614.
doi: 10.3390/nu10050614.

Cost-Effectiveness of Product Reformulation in Response to the Health Star Rating Food Labelling System in Australia

Ana Maria Mantilla Herrera  1   2 , Michelle Crino  3 , Holly E Erskine  4   5   6   7 , Gary Sacks  8 , Jaithri Ananthapavan  9   10 , Cliona Ni Mhurchu  11   12 , Yong Yi Lee  13   14
Affiliations

Cost-Effectiveness of Product Reformulation in Response to the Health Star Rating Food Labelling System in Australia

Ana Maria Mantilla Herrera et al. Nutrients. .

Erratum in

Abstract

The Health Star Rating (HSR) system is a voluntary front-of-pack labelling (FoPL) initiative endorsed by the Australian government in 2014. This study examines the impact of the HSR system on pre-packaged food reformulation measured by changes in energy density between products with and without HSR. The cost-effectiveness of the HSR system was modelled using a proportional multi-state life table Markov model for the 2010 Australian population. We evaluated scenarios in which the HSR system was implemented on a voluntary and mandatory basis (i.e., HSR uptake across 6.7% and 100% of applicable products, respectively). The main outcomes were health-adjusted life years (HALYs), net costs, and incremental cost-effectiveness ratios (ICERs). These were calculated with accompanying 95% uncertainty intervals (95% UI). The model predicted that HSR-attributable reformulation leads to small changes [corrected] in mean population energy intake (voluntary: -0.98 kJ/day; mandatory: -11.81 kJ/day). [corrected]. These are likely to result in changes in mean body weight (voluntary: -0.01 kg [95% UI: -0.012 to -0.006]; mandatory: -0.11 kg [95% UI: -0.14 to -0.07, and HALYs gained [corrected] (voluntary: 4207 HALYs gained [corrected] [95% UI: 2438 to 6081]; mandatory: 49,949 HALYs gained [95% UI: 29,291 to 72,153]). The HSR system [corrected] could be considered cost-effective relative to a willingness-to-pay threshold of A$50,000 per HALY (incremental cost effectiveness ratio for voluntary: [corrected] A$1728 per HALY [95% UI: dominant to 10,445] and mandatory: A$4752 per HALY [95% UI: dominant to 16,236]).

Keywords: Health Star Rating; cost-effectiveness; economic evaluation; front-of-pack labelling; obesity prevention.

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Conflict of interest statement

Cliona Ni Mhurchu is a member of the New Zealand Health Star Rating Advisory Group. The New Zealand Health Star Rating Advisory Group had no role in in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Michelle Crino interacts regularly on a non-financial basis with multiple large corporations in the food processing industry and the quick-service restaurant industry in Australia and overseas as a part of her work to improve the quality of the food supply.

Figures

Figure 1
Figure 1
Intervention pathway for the Health Star Rating (HSR) system.
Figure 2
Figure 2
Cost-effectiveness plane for the HSR system under the voluntary scenario (6.7% uptake).
Figure 3
Figure 3
Cost-effectiveness plane for the HSR system under the mandatory scenario (100% uptake).
Figure 4
Figure 4
Cost-effectiveness plane for sensitivity analyses of the HSR-attributable reformulation under the voluntary scenario.
See this image and copyright information in PMC

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