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Table 5 Population level results for the costs and health gain of the four sodium reduction interventions (95 % uncertainty intervals in parentheses)a and compared with previous interventions [5] using the same model (considered in the Discussion)

From: The health gains and cost savings of dietary salt reduction interventions, with equity and age distributional aspects

Modelled intervention Health gain (QALYs for remainder of the cohort’s life) Health system cost (NZ$; millions) for remainder of the cohort’s life Incremental cost-effectiveness ratio (ICER)
“Do nothing” comparatorb 33,200,000 (33,000,000 to 33,500,000) 162,000 (146,000 to 180,000) -
1) Salt substitution at the 59 % level (processed food) 294,000 (238,000 to 359,000) −1500 (−1980 to − 1090) Dominant
2) “Sinking lid” for salt supply to the marketc 211,000 (170,000 to 255,000) −1110 (−1460 to − 830) Dominant
3) “Salt tax”c 195,000 (159,000 to 237,000) −1000 (−1320 to − 740) Dominant
4) Salt substitution at 25 % 121,000 (97,300 to 147,000) −620 (−820 to − 450) Dominant
5) Mandatory 25 % reduction of sodium in all processed foods (“Mandatory-All”c) 110,000 (87,500 to 135,000) −600 (−800 to − 440) Dominant
6) UK Package (media campaign and voluntary action by industry)c 85,100 (69,600 to 102,000) −440 (−570 to − 320) Dominant
7) Mandatory 25 % reduction of sodium in bread, processed meats and sauces (“Mandatory-3G” c) 61,700 (49,700 to 74,900) −340 (−440 to − 240) Dominant
8) Tight limits on sodium in bread (280 mg/100 g) 43,500 (34,700 to 52,800) −220 (−290 to − 160) Dominant
9) UK style “Mass Media Campaign”c 25,200 (14,200 to 36,700) −120 (−200 to − 62) Dominant
10) Modest limits on sodium in bread (400 mg/100 g) 15,600 (12,600 to 18,900) −83 (−110 to − 61) Dominant
11) Endorsement Label Programmec(current practice in NZ) 7900 (5500 to 10,400) −34 (−52 to − 19) Dominant
12) Dietary counselling by dietitiansc(current practice in NZ) 200 (100 to 330) 6.90 (4.20 to 10.2) NZ$36,900 per QALY gained
  1. aBased on 2000 Monte Carlo simulations for the NZ adult population aged 35+ years and alive in 2011 modelled out to death or age 100. Discount rate: 3 %. Numbers are rounded to two or three meaningful digits
  2. bNo intervention costs are included in this “do nothing comparator” (i.e., the costs of the currently existing programmes of “dietary counselling by dietitians” and the “Endorsement Label Programme”[5] are removed)
  3. cFor further details see this previous work [5] but in summary: Sinking Lid the amount of food-grade salt released onto the NZ market is reduced annually to the point where the recommended level of sodium intake is achieved (2300 mg/d), Salt Tax an excise tax is applied and increased up to the point where the recommended level of sodium intake is achieved (2300 mg/d), Mandatory-All reduction of sodium in all processed foods by 25 % relative to existing levels, UK Package the mix of media campaign, voluntary food reformulation and food labelling changes used in the UK which resulted in a 15 % reduction in 24-h urinary sodium over 7 years in the adult population, Mandatory-3G mandatory reduction of sodium in the manufacture of breads, processed meats and sauces (by 25 % in each group), UK Mass Media Campaign just the mass media campaign part of the UK Package (detailed above), Endorsement Label Programme a programme involving an endorsement label run by the Heart Foundation (part of current practice in NZ), Counselling dietary counselling by dietitians to reduce sodium intake (part of current practice in NZ)