Cost-Effectiveness and Health Equity Improvements From Excluding Sugar-Sweetened Beverages From the Supplemental Nutrition Assistance Program.

Abstract

Excluding sugar-sweetened beverages from eligible purchases in the Supplemental Nutrition Assistance Program has been proposed as a strategy to improve diet quality and health. This study estimates the cost-effectiveness of this policy and its potential impact on health equity. The Childhood Obesity Intervention Cost-Effectiveness Study microsimulation and systematic review process was used in 2024 to estimate the potential impact of excluding sugar-sweetened beverages from Supplemental Nutrition Assistance Program-eligible purchases over a 10-year period (2023-2032) for the U.S. Health outcomes related to excess weight, costs, and relative changes in obesity prevalence by income, race, and ethnicity groups in 2032 were estimated. The policy is projected to be cost-saving, prevent 279,000 cases of obesity (95% uncertainty interval=149,000-446,000), and contribute 115,000 (95% uncertainty interval=60,100-187,000) quality-adjusted life years gained over 10 years among Supplemental Nutrition Assistance Program participants. The policy could save an estimated $2.75 billion in healthcare costs related to excess weight over 10 years, resulting in $3.35 in healthcare cost savings per dollar spent on implementation. Reductions in obesity prevalence were estimated to be 3.5 times greater among individuals with income ≤130% of the federal poverty level than the overall mean and 3-3.5 times greater among non-Hispanic Black and Hispanic individuals than among non-Hispanic White individuals. Excluding sugar-sweetened beverages from Supplemental Nutrition Assistance Program-eligible purchases could be a cost-saving strategy to improve health and health equity between income, racial, and ethnic groups. The U.S. Department of Agriculture could use pilot studies to test the real-world effects of excluding sugar-sweetened beverages from the Supplemental Nutrition Assistance Program.