Tschampl Cynthia A, Tabata-Kelly Masami, Lee Mary R, Soranno Elena, Barman Upanita, Raffoul Amanda, Austin S Bryn
The Heller School for Social Policy and Management, Brandeis University, Waltham, MA 02453, United States.
Population Health Sciences, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA 01655, United States.
Health Aff Sch. 2025 Jan 22;3(1):qxaf002. doi: 10.1093/haschl/qxaf002. eCollection 2025 Jan.
Over-the-counter diet pills and muscle-building supplements are linked to increased eating disorder diagnoses, especially among youth. With limited regulatory oversight, minors may unknowingly consume harmful substances leading to other adverse effects. Massachusetts has proposed restricting sales to individuals under 18 years. However, concerns about health equity and unintended consequences arise when proposing new policies. We conducted a cost-effectiveness analysis of the proposed age-restriction policy compared to the status quo, focusing on 2 closed cohorts of males and females aged 0-17 years in Massachusetts over a 30-year time horizon. We evaluated the impact from both societal and health systems' perspectives and further assessed equity implications by modeling 3 racial/ethnic subgroups. The policy is projected to prevent 57 034 eating disorder cases and over 46 000 additional adverse medical events (eg, liver injuries). It would yield 51 749 quality-adjusted life years and generate healthcare savings of $14 million and societal savings of $30 million annually. The Latine subpopulation would see the highest per capita health benefits followed by Black and White residents, respectively. Restricting the sale of these supplements to minors offers both health and economic benefits. These findings underscore the policy's effectiveness, fiscal responsibility, and positive equity impacts, providing confidence for policymakers and the public.
非处方减肥药和增肌补充剂与饮食失调诊断增加有关，尤其是在青少年中。由于监管监督有限，未成年人可能在不知情的情况下摄入有害物质，从而导致其他不良影响。马萨诸塞州已提议限制向18岁以下个人销售此类产品。然而，在提出新政策时，会出现对健康公平性和意外后果的担忧。我们对拟议的年龄限制政策与现状进行了成本效益分析，重点关注马萨诸塞州0至17岁的两个封闭男性和女性队列，时间跨度为30年。我们从社会和卫生系统的角度评估了影响，并通过对三个种族/族裔亚组进行建模进一步评估了公平性影响。预计该政策将预防57034例饮食失调病例和超过46000例额外的不良医疗事件（如肝损伤）。它将产生51749个质量调整生命年，每年节省医疗保健费用1400万美元，节省社会成本3000万美元。拉丁裔亚人群体将获得最高的人均健康益处，其次是黑人和白人居民。限制向未成年人销售这些补充剂既带来健康益处，也带来经济效益。这些发现强调了该政策的有效性、财政责任和积极的公平影响，为政客和公众提供了信心。
