title: Cost Effectiveness of a Sugar-Sweetened Beverage Excise Tax in the U.S.
abstract: BACKGROUND
  Reducing sugar-sweetened beverage consumption through taxation is a promising public health response to the obesity epidemic in the U.S. This study quantifies the expected health and economic benefits of a national sugar-sweetened beverage excise tax of $0.01/ounce over 10 years.
  
  
  METHODS
  A cohort model was used to simulate the impact of the tax on BMI. Assuming ongoing implementation and effect maintenance, quality-adjusted life-years gained and disability-adjusted life-years and healthcare costs averted were estimated over the 2015-2025 period for the 2015 U.S.
  
  
  METHODS
  Costs and health gains were discounted at 3% annually. Data were analyzed in 2014.
  
  
  RESULTS
  Implementing the tax nationally would cost $51 million in the first year. The tax would reduce sugar-sweetened beverage consumption by 20% and mean BMI by 0.16 (95% uncertainty interval [UI]=0.06, 0.37) units among youth and 0.08 (95% UI=0.03, 0.20) units among adults in the second year for a cost of $3.16 (95% UI=$1.24, $8.14) per BMI unit reduced. From 2015 to 2025, the policy would avert 101,000 disability-adjusted life-years (95% UI=34,800, 249,000); gain 871,000 quality-adjusted life-years (95% UI=342,000, 2,030,000); and result in $23.6 billion (95% UI=$9.33 billion, $54.9 billion) in healthcare cost savings. The tax would generate $12.5 billion in annual revenue (95% UI=$8.92, billion, $14.1 billion).
  
  
  CONCLUSIONS
  The proposed tax could substantially reduce BMI and healthcare expenditures and increase healthy life expectancy. Concerns regarding the potentially regressive tax may be addressed by reduced obesity disparities and progressive earmarking of tax revenue for health promotion.
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Electronic address: michael.long@mail.harvard.edu.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Long
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Gortmaker
authors.affiliation: Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Zachary J
authors.initials: ZJ
authors.lastname: Ward
authors.affiliation: Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Resch
authors.affiliation: Deakin Health Economics, Deakin University, Melbourne, Victoria, Australia.
authors.forename: Marj L
authors.initials: ML
authors.lastname: Moodie
authors.affiliation: WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, Victoria, Australia.
authors.forename: Gary
authors.initials: G
authors.lastname: Sacks
authors.affiliation: WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, Victoria, Australia; Section of Epidemiology and Biostatistics, the School of Population Health, University of Auckland, New Zealand.
authors.forename: Boyd A
authors.initials: BA
authors.lastname: Swinburn
authors.affiliation: Deakin Health Economics, Deakin University, Melbourne, Victoria, Australia.
authors.forename: Rob C
authors.initials: RC
authors.lastname: Carter
authors.affiliation: Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, New York.
authors.forename: Y
authors.initials: Y
authors.lastname: Claire Wang
mesh_terms: D001628:Beverages / Q000145:classification / Q000191:economics*; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006801:Humans; D009765:Obesity / Q000453:epidemiology*; D019057:Quality-Adjusted Life Years; D013549:Sweetening Agents / Q000191:economics*; D013660:Taxes / Q000331:legislation & jurisprudence*; D014481:United States
chemical_list: D013549:Sweetening Agents