Modelling the health and economic impact of sugary sweetened beverage tax in Canada

Background: With the increasing concerns about the health and economic burden attributed to sugar-sweetened beverages (SSBs) consumption, SSB taxation has been proposed and implemented in many countries. Many previous economic evaluations of SSB taxation have shown that this kind of policy is cost-effective. However, the magnitude of impact varies. This study aims to design a comprehensive model to estimate the impact and cost-effectiveness of the SSB tax in Canada. Methods: A proportional multi-state life table-based Markov model was chosen to estimate the impacts of SSB tax in Canada. The health-related quality of life (including disability-adjusted life years (DALYs) and quality-adjusted life years (QALYs)), the costs (including health care costs and intervention costs), and the tax revenue were the main health and economic outcomes. We compared the simulated SSB tax with the current practice from the public health care payer perspective, and the tax was applied to the 2015 adult Canadian population up to 100 years. The economic model was built following guidelines from the Canadian Agency for Drugs and Technologies in Health. Results: After implementing a CAD$0.015/oz SSB tax, 282,104 cases of overweight and obesity, 210,542 cases of diseases, and 2,189 deaths could be prevented. The simulated SSB tax has the potential to avert 2.3 million DALYs, gain 1.5 million QALYs, and save CAD$32,583 million in health care costs in a lifetime period. The incremental cost-effectiveness ratio for the SSB tax was CAD$ -24,933/QALY. The SSB tax with different tax levels (CAD$0.01/oz and CAD$0.02/oz) remained cost-effective. Conclusion: Implementing the SSB tax in Canada is a potential cost-effective policy option for reducing obesity and related chronic diseases. The model built in this study provides a more accurate estimate of health and economic impact of SSB tax and could be used to estimate other sugar tax options.