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The cost-effectiveness of removing television advertising of high-fat and/or high-sugar food and beverages to Australian children

International Journal of Obesity volume 33, pages 1094–1102 (2009)Cite this article

Abstract

Objective:

To model the health benefits and cost-effectiveness of banning television (TV) advertisements in Australia for energy-dense, nutrient-poor food and beverages during children's peak viewing times.

Methods:

Benefits were modelled as changes in body mass index (BMI) and disability-adjusted life years (DALYs) saved. Intervention costs (AUD$) were compared with future health-care cost offsets from reduced prevalence of obesity-related health conditions. Changes in BMI were assumed to be maintained through to adulthood. The comparator was current practice, the reference year was 2001, and the discount rate for costs and benefits was 3%. The impact of the withdrawal of non-core food and beverage advertisements on children's actual food consumption was drawn from the best available evidence (a randomized controlled trial of advertisement exposure and food consumption). Supporting evidence was found in ecological relationships between TV advertising and childhood obesity, and from the effects of marketing bans on other products. A Working Group of stakeholders provided input into decisions surrounding the modelling assumptions and second-stage filters of ‘strength of evidence’, ‘equity’, ‘acceptability to stakeholders’, ‘feasibility of implementation’, ‘sustainability’ and ‘side-effects’.

Results:

The intervention had a gross incremental cost-effectiveness ratio of AUD$ 3.70 (95% uncertainty interval (UI) $2.40, $7.70) per DALY. Total DALYs saved were 37 000 (95% UI 16 000, 59 000). When the present value of potential savings in future health-care costs was considered (AUD$ 300m (95% UI $130m, $480m), the intervention was ‘dominant’, because it resulted in both a health gain and a cost offset compared with current practice.

Conclusions:

Although recognizing the limitations of the available evidence, restricting TV food advertising to children would be one of the most cost-effective population-based interventions available to governments today. Despite its economic credentials from a public health perspective, the initiative is strongly opposed by food and advertising industries and is under review by the current Australian government.

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Acknowledgements

The Assessing Cost-Effectiveness in Obesity (ACE-Obesity) project was funded by the Victorian Government Department of Human Services, Australia. We thank members of the ACE-Obesity working group for their input into the project: Michael Ackland (Deputy Chair), Bill Bellew, John Catford, Elizabeth Devlin, Helen Egan, Bonnie Field, Tim Gill, John Goss, Robert Hall (Chair), Brian Harrison, Kellie-Ann Jolly, Mark Lawrence, Amanda Lee, Tony Mc Bride, Karen McIntyre, Jan Norton, Anna Peeters, Theo Vos, Melissa Wake and Rowland Watson. We also thank Leah Galvin, who worked on this topic as part of her postgraduate studies, and Professor Tim Olds, who assisted with information requests from the latest national children's nutrition and physical activity survey.

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Authors and Affiliations

  1. Health Economics Unit, Public Health Research, Evaluation and Policy Cluster, Deakin University, Burwood, Victoria, Australia

    A Magnus & R Carter

  2. Department of Human Services, Public Health Branch, 50 Lonsdale Street, Melbourne, Victoria, Australia

    M M Haby

  3. WHO Collaborating Centre for Obesity Prevention, Public Health Research, Evaluation and Policy Cluster, Deakin University, Melbourne, Victoria, Australia

    B Swinburn

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Correspondence to A Magnus.

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Magnus, A., Haby, M., Carter, R. et al. The cost-effectiveness of removing television advertising of high-fat and/or high-sugar food and beverages to Australian children. Int J Obes 33, 1094–1102 (2009). https://doi.org/10.1038/ijo.2009.156

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