Use of simulation models in health economic evaluation studies of dietary salt-reduction policies for cardiovascular disease prevention

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  • KATO Hiroki
    International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition
  • IKEDA Nayu
    International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition
  • SUGIYAMA Takehiro
    International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine Department of Health Services Research, Faculty of Medicine, University of Tsukuba Health Services Research & Development Center, University of Tsukuba
  • NOMURA Marika
    International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition Department of Human Development, Japan International Cooperation Agency
  • YOSHITA Katsushi
    Graduate School of Human Life Science and Nutrition, Osaka City University
  • NISHI Nobuo
    International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition

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Other Title
  • 海外における減塩政策による循環器疾患予防に関するシミュレーションモデルを用いた医療経済的評価研究の現況
  • カイガイ ニ オケル ゲンエン セイサク ニ ヨル ジュンカンキ シッカン ヨボウ ニ カンスル シミュレーションモデル オ モチイタ イリョウ ケイザイテキ ヒョウカ ケンキュウ ノ ゲンキョウ

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Abstract

<p>Objectives　Social security costs related to the healthcare and long-term care of patients with cardiovascular diseases is a national burden that is expected to grow as Japan's population ages. Nutritional policies for improving the nation's diet could prevent cardiovascular diseases, but scientific evidence on their costs and outcomes is limited. This study gives an overview of health economic evaluation studies on population-wide dietary salt-reduction policies that have been instituted for the purposes of cardiovascular disease prevention. Thus, this study provides background information for the development of evaluation methods that can be utilized in Japan for analyzing the effects of nutritional policies on public health and social security cost containment.</p><p>Methods　We extracted representative health economic simulation models that are used for predicting the effects of cardiovascular disease-related interventions: Cardiovascular Disease Policy Model, IMPACT Coronary Heart Disease Policy and Prevention Model, US IMPACT Food Policy Model, Assessing Cost-Effectiveness (ACE) approach to priority-setting, and Prevention Impacts Simulation Model (PRISM). Next, we collected original articles on studies that used these models for assessing the costs and effects of national population-wide dietary salt-reduction policies. We then outlined the background, structure, and applied studies associated with each model.</p><p>Results　The five models utilized Markov cohort simulation, microsimulation, proportional multistate life tables, and system dynamics to predict the effect of dietary salt-reduction policies on blood pressure reduction and cardiovascular disease prevention. The models were applied to countries such as Australia, England, and the United States to simulate long-term (10 years to lifetime) costs and effects. These applied studies examined policies that included health promotion campaigns, sodium labels on the front of food packages, and mandatory or voluntary reformulation by the food industry to reduce the salt content of processed foods.</p><p>Conclusion　Health economic simulation modeling is actively being used to evaluate scientific evidence on the costs and outcomes of national dietary salt-reduction policies. Similarly, leveraging simulation modeling techniques could facilitate the evaluation and planning of dietary salt-reduction policies and other nutritional policies in Japan.</p>

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