APPLICATION OF COST/BENEFIT ANALYSIS TO

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APPLICATION OF COST/BENEFIT ANALYSIS TO NEW/EVOLVING FOOD TECHNOLOGIES Jason P.H. Jones, Ph.D. Senior Research Economist RTI International, Research Triangle Park, North Carolina IFT 2016, Chicago IL July 2016

Measuring health economic benefits Economists use models to evaluate costs of individual and society choices Examples: 1. Cost-benefit analysis (CBA) 2. Cost-effectiveness analysis (CEA) 3. Cost-of-illness analysis (COI) CBA and CEA measure two or more alternative treatments; thus require knowledge of costs of those treatments COI measures the direct and indirect costs of a specific disease, e.g. CVD

The Mediterranean diet valuation Economic benefits of the Mediterranean-style diet consumption in Canada and the United States Mohammad M.H. Abdullah 1,2, Jason P.H. Jones 3 and Peter J.H. Jones 1,2 * 1 Richardson Centre for Functional Foods and Nutraceuticals; 2 Department of Human Nutritional Sciences, University of Manitoba, Canada; 3 Department of Agricultural Economics, Texas A&M University, USA. Abdullah, M. M., Jones, J. P., & Jones, P. J. (2015). Economic benefits of the Mediterranean-style diet consumption in Canada and the United States. Food & nutrition research, 59.

The Mediterranean diet valuation An established model of healthy eating behavior Plant-based foods (fruits, vegetables, whole grains) and olive oil daily; dairy products, fish, pulses/nuts, egg, and poultry weekly; red meat monthly; and wine during meals Superior evidence; >80% of CHD could be avoided by MedDiet

The Mediterranean diet valuation Same concept as in the plant sterol valuation Objective: To determine the potential economic savings associated with closer adherence to a MedDiet in Canada and the USA Three-step cost-of-illness analysis MedDiet success rate (%) CVD reduction (%) Cost reduction ($)

Calculation of cost reduction Calculation of the reduction in costs associated with CHD due to a reduction in the overall prevalence of CHD Mainly based on national databases Health Canada s Economic Burden of Illness report U.S. Medical Expenditure Panel Survey data Adjusted to current dollars by adjusting for healthrelated consumer price index 84% of costs is fixed and 16% is variable Physiotherapists (1%), all other health professionals (4.7%), ambulance (4.2%), home care (6.2%), and all other health expenditures (7.2%)

The Mediterranean diet valuation Scenario Ideal Optimistic Pessimistic Verypessimistic Adoption rate (%) 50.0 25.0 15.0 5.0 CVD incidence reduction (%) 60.0 30.0 20.0 10.0 If between 5% and 50% of the Canadian and American populace follow a MedDiet... CAD$41.9 million to $2.5 billion in Canada and USD$1.0 to $62.8 billion in the U.S., would accrue as total annual savings in costs, given a worst-case through best-case scenarios A trip to outer space would cost about $200 million!

The dietary fibre and constipation valuation Economic benefits of increased dietary fibre intake and reductions in rates of functional constipation in Canada: A cost-of-illness analysis Mohammad M.H. Abdullah 1, Collin L. Gyles 2, Christopher P.F. Marinangeli 3, Jared G. Carlberg 2, Peter J.H. Jones 1 1 Department of Human Nutritional Sciences and Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Manitoba; 2 Department of Agribusiness & Agricultural Economics, University of Manitoba, Winnipeg, Manitoba; 3 Kellogg Canada Inc., Mississauga, Ontario, Canada Abdullah, M. M., Gyles, C. L., Marinangeli, C. P., Carlberg, J. G., & Jones, P. J. (2015). Dietary fibre intakes and reduction in functional constipation rates among Canadian adults: a cost-of-illness analysis. Food & nutrition research, 59.

Dietary fibre and constipation Chronic Constipation Affects up to 27% of the population of Western countries Increasing dietary fibre intake is commonly recommended as a first tactic in management of constipation, with 25 g/day considered effective 1.8% reduction in constipation prevelance per 1 g/d increase in fibre intake

The dietary fibre and constipation valuation Summary of the input parameters for the cost savings assessment model utilized Parameter Men Women Source Current fibre intake, g/day 19.1 15.6 Belanger et al. (2004) Target fibre intake, g/day 38 25 IOM (2002) 20 25 30 35 20 25 30 35 Assumption for the economic valuation of incremental increases in intake 20.1 16.6 Assumption for economic valuation of a per gram increase in intake Constipation reduction per 1 g fibre intake, % Population expected to respond to fibre intake, % 1.8 1.8 Dukas et al. (2003) 85 85 Assumption

The dietary fibre and constipation valuation If fibre intakes increase to levels corresponding to Institute of Medicine s adequate intake of 38 g/day for men and 25 g/day for women... Up to CAD$45.6 million in healthcare cost could be saved annually (best-case scenario) Each 1 g/day increase in dietary fibre estimated to result in total annual healthcare cost savings ranging between CAD$0.2 to $3.5 million

Constipation-related healthcare cost savings, CAD$ million The dietary fibre and constipation valuation 21 18 15 12 9 6 3 0 Universal Optimistic Pessimistic Very pessimistic Theoretical probability curve Similar analysis for dietary fibre and T2D/CVD

Stakeholder synergy Scientists provide the health- and economic-based evidence Scientists Regulators set clear guidelines for healthy eating and lifestyle Food industry creates and advertises and markets healthy products Consumers Industry Educators Regulators

Final remarks and conclusions Modeling estimates shed light on the economic value of nutrition and functional foods Importance of communicating the economic benefits of easily achievable dietary changes to the general public and stakeholders alike Setting the stage for public policy strategies that advocate healthy-eating behavioural change to address and manage the challenges of healthcare and societal systems

Acknowledgements Mohammad Abdullah Jared Calberg Collin Gyles Stephanie Jew Chris Marinangeli Irene Lenoir-Wijnkoop ILSI North America Canadian Institute for Health Research Natural Sciences and Engineering Research Council Kellogg Canada