Abstract 022: Cost-Effectiveness of Financial Incentives and Disincentives for Improving Diet and Health Through the Supplemental Nutrition Assistance Program

• DOI: 10.1161/circ.137.suppl_1.022
• Publication Date: 2021-07-02T20:04:45Z
• Authors: Junxiu Liu; Dariush Mozaffarian; Stephen Sy; Yue Huang; Yujin Lee; Parke Wilde; Shafika Abrahams-...; Thiago de Souza V...; Tom Gaziano; Renata Micha
• Keywords: Added sugar

Introduction: The 2018 Farm Bill represents a major opportunity to reduce disparities in diet and health. largest component is the Supplemental Nutrition Assistance Program (SNAP), feeding 1 6 Americans. Potential options include subsidizing fruits & vegetables (F&V), restricting sugar-sweetened beverages (SSBs), or implementing broader food incentive/disincentive framework that preserves choice. Their comparative health impacts cost-effectiveness are not established. Methods: Using validated microsimulation model (CVD PREDICT), we estimated changes CVD events, quality-adjusted life-years (QALYs), costs, of 3 policy scenarios SNAP adults: 1) 30% subsidy on F&V; 2) F&V + SSB restriction; 3) F&V, whole grains, nuts/seeds, seafood, plant-based oils, disincentive SSBs, junk food, processed meats. Model inputs included national data from NHANES (2009-2014), effects pilots pricing meta-analyses, diet-disease policy, subsidy, healthcare costs. Results: From societal perspective, all were cost-savings at 5, 10, 20 y lifetime ( Table ). At 5 y, would prevent 32,218 gain 18,072 QALYs, save $1.04B ($6.05B lifetime). Corresponding values for restriction 63,898, 45,772, $4.47B ($38.83B); preserved choice, 65,078, 26,663, $3.98B ($29.90B). Government affordability varied by program duration whether costs adults participants included. Scenario was generally most cost-effective -saving, followed scenario 2 then 1; over government perspective. Conclusions: Financial incentives/disincentives through could generate substantial benefits be cost savings.