Impact of Sugar-Sweetened Beverage Taxation Scenarios in Germany: A Comparative Modelling Study

• Published in: European journal of public health 2022-10, Vol.32 (Supplement_3)
• Main Authors: Emmert-Fees, KMF, Felea, A, Kypridemos, C, Scarborough, P, Laxy, M
• Format: Article
• Language: English
• Subjects: Beverages; Body weight; Cardiovascular diseases; Costs; Diabetes; Diabetes mellitus (non-insulin dependent); Diet; Dietary intake; Disease; Economic impact; Economics; Excise taxes; Food intake; Health care; Health care expenditures; Health care policy; Health policy; Health services; Heart diseases; Impact analysis; Modelling; Obesity; Parallel Programme; Population; Public health; Sex; Simulation; Simulation models; Sugar; Taxation; Weight reduction; Workflow
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/ckac129.340

Objectives Taxing sugar-sweetened beverages (SSBs) is recommended to reduce the burden of obesity, cardiovascular disease (CVD) and type 2 diabetes (T2DM). The objective of this study was to quantify the potential long-term health and economic impact of different SSBs taxation scenarios in Germany using simulation models with different granularity. Methods We used a multi-state life table Markov cohort (MSLT) and a microsimulation (IMPACT) model to simulate the impact of different SSB taxation assumptions and scenarios on CVD and T2DM in the German population aged 20 years and older over 20 years. Data sources included official population counts, anthropometric and dietary intake data from national surveys and published meta-analyses. Change in beverage consumption by sex and age under different taxation scenarios was estimated using de-novo national price elasticities and changes in body weight were based on an energy equilibrium model. We projected incremental disability-adjusted life years (DALYs) and healthcare costs, comparing results between both models. Results Preliminary results from the MSLT model show that a 20% SSB excise tax in Germany could lead to moderate body weight reductions across all age-sex groups. Over 20 years, the tax would reduce healthcare costs by €753 million [95% CI: 527; 1,021] and save 24,380 DALYs [18,460; 33,900] from T2DM alone. Health and economic gains largely depend on the relevance of substitution effects, tax amount and taxed beverage categories. Results including CVD and comparisons with the IMPACT model are work-in-progress. Conclusions We show that SSBs taxation in Germany has the potential to reduce healthcare costs and improve population health. The impact of any SSB tax depends on its implementation scenario, which behavioural assumptions hold, and the obesity-related disease outcomes considered for its evaluation. Further research should compare various obesity prevention approaches to support health policy priority setting. Key messages * Taxation of sugar-sweetened beverages can reduce healthcare costs and improve population health in Germany. * The estimated health and economic impact of sugar-sweetened beverage taxation critically depends on tax design and behavioural modelling assumptions.