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提高酒精价格以预防肥胖:在澳大利亚引入统一的容积税和酒类最低限价的潜在成本效益。

Increasing the Price of Alcohol as an Obesity Prevention Measure: The Potential Cost-Effectiveness of Introducing a Uniform Volumetric Tax and a Minimum Floor Price on Alcohol in Australia.

机构信息

Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia.

Deakin Health Economics (DHE), Institute for Health Transformation, Deakin University, Burwood, VIC 3125, Australia.

出版信息

Nutrients. 2020 Feb 26;12(3):603. doi: 10.3390/nu12030603.

Abstract

The objective of this study was to estimate, from an obesity prevention perspective, the cost-effectiveness of two potential policies that increase the price of alcohol in Australia: a volumetric tax applied to all alcohol (Intervention 1) and a minimum unit floor price (Intervention 2). Estimated changes in alcoholic drink consumption and corresponding changes in energy intake were calculated using the 2011-12 Australian Health Survey data, published price elasticities, and nutrition information. The incremental changes in body mass index (BMI), BMI-related disease outcomes, healthcare costs, and Health Adjusted Life Years (HALYs) were estimated using a validated model. Costs associated with each intervention were estimated for government and industry. Both interventions were estimated to lead to reductions in mean alcohol consumption (Intervention 1: 20.7% (95% Uncertainty Interval (UI): 20.2% to 21.1%); Intervention 2: 9.2% (95% UI: 8.9% to 9.6%); reductions in mean population body weight (Intervention 1: 0.9 kg (95% UI: 0.84 to 0.96); Intervention 2: 0.45 kg (95% UI: 0.42 to 0.48)); HALYs gained (Intervention 1: 566,648 (95% UI: 497,431 to 647,262); Intervention 2: 317,653 (95% UI: 276,334 to 361,573)); and healthcare cost savings (Intervention 1: $5.8 billion (B) (95% UI: $5.1B to $6.6B); Intervention 2: $3.3B (95% UI: $2.9B to $3.7B)). Intervention costs were estimated as $24M for Intervention 1 and $30M for Intervention 2. Both interventions were dominant, resulting in health gains and cost savings. Increasing the price of alcohol is likely to be cost-effective from an obesity prevention perspective in the Australian context, provided consumers substitute alcoholic beverages with low or no kilojoule alternatives.

摘要

本研究旨在从预防肥胖的角度,评估提高澳大利亚酒类价格的两项潜在政策的成本效益,这两项政策分别是:对所有酒类征收体积税(干预 1)和设定最低单位价格(干预 2)。使用 2011-12 年澳大利亚健康调查数据、公布的价格弹性和营养信息,计算出饮酒量的估计变化和相应的能量摄入变化。使用验证模型估计体重指数(BMI)的增量变化、与 BMI 相关的疾病结果、医疗保健成本和健康调整生命年(HALYs)。为政府和行业估算了与每项干预措施相关的成本。这两项干预措施都预计会导致平均酒精摄入量减少(干预 1:20.7%(95%置信区间(UI):20.2%至 21.1%);干预 2:9.2%(95% UI:8.9%至 9.6%));平均人群体重减轻(干预 1:0.9 公斤(95% UI:0.84 至 0.96);干预 2:0.45 公斤(95% UI:0.42 至 0.48));获得的 HALYs 增加(干预 1:566648(95% UI:497431 至 647262);干预 2:317653(95% UI:276334 至 361573))和医疗保健成本节约(干预 1:58 亿美元(B)(95% UI:5.1B 至 6.6B);干预 2:33 亿美元(95% UI:2.9B 至 3.7B))。干预成本估计为干预 1 为 2400 万澳元,干预 2 为 3000 万澳元。这两项干预措施均具有优势,既能带来健康收益,又能节省成本。从预防肥胖的角度来看,在澳大利亚背景下,提高酒类价格可能具有成本效益,前提是消费者用低热量或无热量的替代品替代酒精饮料。

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