Background: To guide resource allocation, policy makers need evidence of the cost-effectiveness of interventions. We summarized such evidence on selected interventions to reduce sodium intake that would be intended as population-wide approaches to control hypertension.
Methods: We conducted a comprehensive literature review of journal articles published in English from January 2000 to May 2010 by searching the databases of PubMed, EMBASE, MEDLINE, and EconLit. We selected original research articles for abstracting the evidence on cost-effectiveness of interventions, cost savings and the costs of intervention implementation.
Results: From the 53 references obtained from the literature search, we identified 11 original research articles that provided relevant information on the medical cost savings, implementation costs, or cost-effectiveness of interventions to reduce sodium intake. The interventions were low in cost, e. g., one study showed that the cost ranged from US$ 0.03 to 0.32 per person per year for awareness campaign through mass media outlets and government regulations on food products in low and middle-income countries. Population-wide interventions for salt reduction are very cost-effective such as only ARS$ 151 per disability-adjusted life-year (DALY) saved in Argentina, whereas statin therapy to lower high cholesterol was $ 70 994 per DALY saved. Another study showed that sodium reduction could save US$ 18 billion in annual US healthcare costs by reducing sodium intake to 2300 mg/day.
Conclusion: The literature provided economic evidence that was in favor of population-wide interventions designed to reduce sodium intake. Reducing the intake of sodium through such initiatives might be one of the best buys in public health. However, the small body of literature and hypothetical scenarios in most studies might limit policy implications of the findings.
Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
Correspondence to Guijing Wang, PhD, Senior Health Economist, Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention (CDC), 4770 Buford Hwy NE, MS K-47, Atlanta, GA 30341-3717, USATel: +1 770 488 4714; fax: +1 770 488 8151; e-mail: email@example.com
Abbreviations: AMI, acute myocardial infarction; ARS, Argentine pesos; CVD, cardiovascular disease; QALY, quality-adjusted life-year; WHO, World Health Organization; WHO-CHOICE, World Health Organization-choosing interventions that are cost effective
Partial results of this manuscript were presented at the World Health Organization (WHO) and Food Standards Agency (FSA) of UK Jointly Convened Technical Meeting on Creating an Enabling Environment for Population-based Salt Reduction Strategies, 1–2 July 2010, London, UK; and at the 2011 Annual Scientific Meeting and Exposition of the American Society of Hypertension Inc., 21–24 May 2011, New York.
Received 28 December, 2010
Revised 16 May, 2011
Accepted 9 June, 2011