Wilcox Meredith L, Mason Helen, Fouad Fouad M, Rastam Samer, al Ali Radwan, Page Timothy F, Capewell Simon, O'Flaherty Martin, Maziak Wasim
Department of Epidemiology, Florida International University, Miami, FL, USA,
Int J Public Health. 2015 Jan;60 Suppl 1:S23-30. doi: 10.1007/s00038-014-0577-3. Epub 2014 Jun 28.
This study presents a cost-effectiveness analysis of salt reduction policies to lower coronary heart disease in Syria.
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.
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.
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.
本研究对叙利亚降低冠心病的减盐政策进行成本效益分析。
在10年时间范围内估算了一项关于减盐的健康促进活动（HP）、包装食品盐含量标签标注（L）、包装食品内盐含量重新配方（R）以及这三种措施组合的成本和效益。如果成本效益比低于该地区设定的38,997美元购买力平价（PPP）阈值，则认为这些政策具有成本效益。进行敏感性分析以考虑盐摄入量减少方面的不确定性。
使用最佳估计值时，HP、L以及R + HP + L均节省成本。其余政策具有成本效益（成本效益比：R = 5,453 PPP/利比亚第纳尔；R + HP = 2,201 PPP/利比亚第纳尔；R + L = 2,125 PPP/利比亚第纳尔）。使用最佳和最大估计值时，R + HP + L带来的效益最大且有净节省，而使用最小估计值时，R + L以最低边际成本具有成本效益。
本研究表明，所有政策均节省成本或具有成本效益，其中重新配方加标签以及包含所有三种方法的综合政策是叙利亚降低冠心病死亡率最有前景的减盐策略。
