Estimated health benefits, costs and cost-effectiveness of eliminating industrial trans - fatty acids in Nigeria: cost-effectiveness analysis.

Autor:	Marklund M; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden matti.marklund@pubcare.uu.se.; Food Policy, The George Institute for Global Health, Newtown, New South Wales, Australia.; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA., Aminde LN; School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia., Wanjau MN; School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia., Ale BM; Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria.; Holo Healthcare, Nairobi, Kenya., Ojo AE; Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria.; Department of Epidemiology and Global Health, University Medical Centre Utrecht, Utrecht, Netherlands., Okoro CE; Federal Capital Territory Primary Health Care Board, Abuja, Nigeria., Adegboye A; National Agency for Food and Drug Administration and Control, Abuja, Federal Capital Territory, Nigeria., Huang L; Food Policy, The George Institute for Global Health, Newtown, New South Wales, Australia., Veerman JL; School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia., Wu JH; Food Policy, The George Institute for Global Health, Newtown, New South Wales, Australia.; School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia., Huffman MD; Food Policy, The George Institute for Global Health, Newtown, New South Wales, Australia.; Washington University in St Louis, St Louis, St Louis, USA., Ojji DB; Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria.; Department of Internal Medicine, Faculty of Clinical Sciences, University of Abuja, Abuja, Federal Capital Territory, Nigeria.
Jazyk:	angličtina
Zdroj:	BMJ global health [BMJ Glob Health] 2024 Apr 17; Vol. 9 (4). Date of Electronic Publication: 2024 Apr 17.
DOI:	10.1136/bmjgh-2023-014294
Abstrakt:	Introduction: Nigeria is committed to reducing industrial trans- fatty acids (iTFA) from the food supply, but the potential health gains, costs and cost-effectiveness are unknown. Methods: The effect on ischaemic heart disease (IHD) burden, costs and cost-effectiveness of a mandatory iTFA limit (≤2% of all fats) for foods in Nigeria were estimated using Markov cohort models. Data on demographics, IHD epidemiology and trans- fatty acid intake were derived from the 2019 Global Burden of Disease Study. Avoided IHD events and deaths; health-adjusted life years (HALYs) gained; and healthcare, policy implementation and net costs were estimated over 10 years and the population's lifetime. Incremental cost-effectiveness ratios using net costs and HALYs gained (both discounted at 3%) were used to assess cost-effectiveness. Results: Over the first 10 years, a mandatory iTFA limit (assumed to eliminate iTFA intake) was estimated to prevent 9996 (95% uncertainty interval: 8870 to 11 118) IHD deaths and 66 569 (58 862 to 74 083) IHD events, and to save US$90 million (78 to 102) in healthcare costs. The corresponding lifetime estimates were 259 934 (228 736 to 290 191), 479 308 (95% UI 420 472 to 538 177) and 518 (450 to 587). Policy implementation costs were estimated at US$17 million (11 to 23) over the first 10 years, and US$26 million USD (19 to 33) over the population's lifetime. The intervention was estimated to be cost-saving, and findings were robust across several deterministic sensitivity analyses. Conclusion: Our findings support mandating a limit of iTFAs as a cost-saving strategy to reduce the IHD burden in Nigeria. Competing Interests: Competing interests: All authors have completed the ICMJE uniform disclosure form and declare the following: MM report grant support from Resolve to Save Lives and the World Health Organization; and travel support from the Nordic Dairy Congress 2022; all outside of the present work. MDH has received travel support from the American Heart Association and World Heart Federation. MDH has an appointment at The George Institute for Global Health, which has a patent, license and has received investment funding with intent to commercialise fixed-dose combination therapy through its social enterprise business, George Medicines. MDH has pending patents for heart failure polypills. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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