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According to a study published March 19 in the open access journal, healthy food prescriptions through Medicare and Medicaid could generate substantial health gains and be very cost-effective PLOS Medicine by Yujin Lee and Dariush Mozaffarian of the Friedman School of Nutrition Science and Policy at Tufts University, Mbadachusetts, USA and colleagues. As reported by the authors, the results support the implementation and evaluation of such programs in private and public health systems.
In almost all countries, health spending continues to increase dramatically, with diet-related diseases being an important factor. Economic incentives offered by health insurance can promote healthier behaviors, but little is known about the health and economic effects of the incentive diet, the main risk factor for diabetes and cardiovascular disease, through Medicare and Medicaid. Orders for fruits, vegetables and other products have just been funded in the United States through the Farm Bill with pilot programs. However, the health impacts, costs, and cost-effectiveness of the programs have not been evaluated on a large scale.
As part of the Food-PRICE project, Lee and colleagues evaluated the health and economic consequences of healthy adult food prescriptions in Medicare and Medicaid, the two largest health and safety programs in Canada. Federal Health Insurance of the United States. cover 1 of 3 Americans.
Using nationally representative data and a validated model, they evaluated two scenarios: (1) 30% incentive to purchase fruit and vegetables (F & L incentive) and 2) 30% incentive the cost of buying several healthy foods. , including fruits, vegetables, whole grains, nuts / seeds, seafood and vegetable oils (incentive to eat a healthy diet).
Over the course of their lives, the study suggests that F & V incentives could prevent 1.93 million cases of cardiovascular disease, including 0.35 million deaths, and save about $ 40 billion in health care. Encouraging healthy eating could prevent 3.28 million cardiovascular diseases, including 0.62 million cardiovascular deaths and 0.12 million diabetes cases, and save $ 100 billion in health care.
Both programs would be very cost-effective from a health and societal perspective, with incremental cost-effectiveness ratios ranging from over $ 9,000 to about $ 18,000 per quality-adjusted life year. Overall, the results suggest that the implementation of healthy food prescriptions in the government's major health programs to promote healthier eating could generate substantial health gains and be very cost-effective.
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research article
Funding:
This research was funded by the National Institutes of Health and the National Institute of Heart, Lung and Blood (R01 HL130735, RM PI; R01 HL115189, PI DM), https: /
Competing interests:
I've read the magazine's policy and the authors of this manuscript have divergent interests: RM reports research funds from the NIH, the Bill & Melinda Gates Foundation and Unilever, as well as fees staff of the World Bank and Bunge. DM reports research funding from National Institutes of Health and Gates Foundation; personal expenses of GOED, Impact Nutrition, Pollock Communications, Bunge, Indigo Agriculture, Amarin, Acasti Pharma, Cleveland Clinic Foundation, America & Test Kitchen and Danone; Scientific Advisory Board, Elysium Health (with stock options), Omada Health and DayTwo; and UpToDate chapter fees, all outside the submitted work. The TAG has also received research funds and / or consulting fees from Astra Zeneca, Novartis, United Health Group, Teva Pharmacueticals and Takeda over the past five years, all outside of the submitted work.
Quote:
Lee Y, Mozaffarian D, Sy S, Huang Y, Liu J, Wilde PE, et al. (2019) Cost-Effectiveness of Financial Incentives to Improve Diet and Health with Medicare and Medicaid: A Microsimulation Study. PLoS Med 16 (3): e1002761. https: /
Affiliations of author:
Friedman School of Science and Nutrition Policy, Tufts University, Boston, Mbadachusetts, United States of America
Brigham and Women's Hospital, Boston, Mbadachusetts, United States of America
Harvard T. H. Chan School of Public Health, Boston, Mbadachusetts, United States of America
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