title: Estimates of the direct and indirect cost savings associated with heart disease that could be avoided through dietary change in the United States.
abstract: OBJECTIVE
  Diets high in saturated fat are associated with elevated risk of heart disease. This study estimates the savings in direct (medical care) costs and indirect (job absenteeism) costs in the US from reductions in heart disease associated with substituting monounsaturated fats (MUFA) for saturated fats.
  
  
  METHODS
  A four-part model of the medical care cost savings from avoided heart disease was estimated using data on 247,700 adults from the 2000-2010 Medical Expenditure Panel Survey (MEPS). The savings from reduced job absenteeism due to avoided heart disease was estimated using a zero-inflated negative binomial model of the number of annual work loss days applied to data on 164,577 adults from the MEPS.
  
  
  RESULTS
  Estimated annual savings in medical care expenditures resulting from a switch from a diet high in saturated fat to a high-MUFA diet totaled ∼ $25.7 billion (95% CI = $6.0-$45.4 billion) in 2010, with private insurance plans saving $7.9 billion (95% CI = $1.8-$14.0 billion), Medicare saving $9.4 billion (95% CI = $2.1-$16.7 billion), Medicaid saving $1.4 billion (95% CI = $0.2-$2.5 billion), and patients saving $2.2 billion (95% CI = $0.5-$3.8 billion). The annual savings in terms of reduced job absenteeism ranges from a lower bound of $600 million (95% CI = $100 million to $1.0 billion) to an upper bound of $1.2 billion (95% CI = $0.2-$2.1 billion) for 2010.
  
  
  CONCLUSIONS
  The data cover only the non-institutionalized population. Decreased costs due to any decreases in the severity of heart disease are not included. Cost savings do not include any reduction in informal care at home.
  
  
  CONCLUSIONS
  Diets high in saturated fat impose substantial medical care costs and job absenteeism costs, and substantial savings could be achieved by substituting MUFA for saturated fat.
authors.affiliation: a Department of Policy Analysis and Management, and Department of Economics , Cornell University , Ithaca , NY , USA.
authors.forename: John
authors.initials: J
authors.lastname: Cawley
authors.affiliation: b Department of Economics , Lehigh University , Bethlehem , PA , USA.
authors.forename: Chad
authors.initials: C
authors.lastname: Meyerhoefer
authors.affiliation: c Nutritional Fundamentals for Health Inc. , Vaudreuil-Dorion , QC , Canada.
authors.forename: Leah G
authors.initials: LG
authors.lastname: Gillingham
authors.affiliation: d Department of Nutritional Sciences , Pennsylvania State University, University Park , PA , USA.
authors.forename: Penny
authors.initials: P
authors.lastname: Kris-Etherton
authors.affiliation: e Richardson Centre for Functional Foods and Nutraceuticals , University of Manitoba , Winnipeg , MB , Canada.
authors.forename: Peter J H
authors.initials: PJ
authors.lastname: Jones
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000368:Aged; D017046:Cost Savings / Q000639:trends*; D017281:Cost of Illness; D019538:Health Care Surveys; D005102:Health Expenditures / Q000639:trends*; D006331:Heart Diseases / Q000178:diet therapy* / Q000191:economics*; D006801:Humans; D008875:Middle Aged; D008962:Models, Theoretical; D014481:United States; D055815:Young Adult
keywords: Diet; MUFA; PUFA; absenteeism costs; heart disease; medical care costs; saturated fat; unsaturated fat