PMID- 31543983
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231013
IS  - 2059-7908 (Print)
IS  - 2059-7908 (Electronic)
IS  - 2059-7908 (Linking)
VI  - 4
IP  - 4
DP  - 2019
TI  - The distributional impact of taxing sugar-sweetened beverages: findings from an 
      extended cost-effectiveness analysis in South Africa.
PG  - e001317
LID - 10.1136/bmjgh-2018-001317 [doi]
LID - e001317
AB  - BACKGROUND: Facing increasing obesity prevalence and obesity-related disease 
      burden, South Africa has devised an obesity prevention strategy that includes a 
      recently implemented tax on the sugar content of sugar-sweetened beverages (SSB). 
      We assess the potential distributional impact (across socioeconomic groups) of 
      this tax on type 2 diabetes mellitus (T2DM) incidence and associated mortality 
      and its financial burden on households. METHODS: We conducted an extended 
      cost-effectiveness analysis of the new 10% tax on SSBs in South Africa, and 
      estimated: the averted premature deaths related to T2DM, the financial benefits 
      to households (out-of-pocket (OOP) medical costs and indirect costs due to 
      productivity losses averted), the increased government tax revenues and 
      healthcare savings for the government, all across income quintiles. FINDINGS: A 
      10% SSB tax increase would avert an estimated 8000 T2DM-related premature deaths 
      over 20 years, with most deaths averted among the third and fourth income 
      quintiles. The government would save about South African rand (ZAR) 2 billion 
      (US$140 million) in subsidised healthcare over 20 years; and would raise 
      ZAR6 billion (US$450 million) in tax revenues per annum. The bottom two quintiles 
      would bear the smallest tax burden increase (36% of the additional taxes). The 
      bottom two income quintiles would also have the lowest savings in OOP payments 
      due to significant subsidisation provided by government healthcare. Lastly, an 
      estimated 32 000 T2DM-related cases of catastrophic expenditures and 12 000 cases 
      of poverty would be averted. CONCLUSIONS: SSB taxation would have a substantial 
      distributional impact on obesity-related premature deaths, cost savings to the 
      government and the financial outcomes of South Africa's population.
FAU - Saxena, Akshar
AU  - Saxena A
AUID- ORCID: 0000-0001-8518-0466
AD  - Economics, Nanyang Technological University, Singapore, Singapore.
AD  - Department of Global Health and Population, Harvard T.H. Chan School of Public 
      Health, Boston, Massachusetts, USA.
FAU - Stacey, Nicholas
AU  - Stacey N
AUID- ORCID: 0000-0002-3572-5314
AD  - SAMRC/Wits Center for Health Economics and Decision Science - PRICELESS SA School 
      of Public Health Faculty of Health Sciences, University of the Witwatersrand, 
      Johannesburg, South Africa.
FAU - Puech, Paula Del Ray
AU  - Puech PDR
AD  - Department of Global Health and Population, Harvard T.H. Chan School of Public 
      Health, Boston, Massachusetts, USA.
FAU - Mudara, Caroline
AU  - Mudara C
AD  - SAMRC/Wits Center for Health Economics and Decision Science - PRICELESS SA School 
      of Public Health Faculty of Health Sciences, University of the Witwatersrand, 
      Johannesburg, South Africa.
FAU - Hofman, Karen
AU  - Hofman K
AD  - SAMRC/Wits Center for Health Economics and Decision Science - PRICELESS SA School 
      of Public Health Faculty of Health Sciences, University of the Witwatersrand, 
      Johannesburg, South Africa.
FAU - Verguet, Stephane
AU  - Verguet S
AUID- ORCID: 0000-0003-4128-0849
AD  - Department of Global Health and Population, Harvard T.H. Chan School of Public 
      Health, Boston, Massachusetts, USA.
LA  - eng
PT  - Journal Article
DEP - 20190821
PL  - England
TA  - BMJ Glob Health
JT  - BMJ global health
JID - 101685275
EIN - BMJ Glob Health. 2019 Sep 18;4(5):e001317corr1. PMID: 31637033
PMC - PMC6730580
OTO - NOTNLM
OT  - South Africa
OT  - diabetes mellitus
OT  - distributional impact
OT  - equity
OT  - extended cost-effectiveness analysis
OT  - soda tax
OT  - sugar-sweetened beverages
COIS- Competing interests: None declared.
EDAT- 2019/09/24 06:00
MHDA- 2019/09/24 06:01
PMCR- 2019/08/21
CRDT- 2019/09/24 06:00
PHST- 2018/11/19 00:00 [received]
PHST- 2019/05/27 00:00 [revised]
PHST- 2019/05/28 00:00 [accepted]
PHST- 2019/09/24 06:00 [entrez]
PHST- 2019/09/24 06:00 [pubmed]
PHST- 2019/09/24 06:01 [medline]
PHST- 2019/08/21 00:00 [pmc-release]
AID - bmjgh-2018-001317 [pii]
AID - 10.1136/bmjgh-2018-001317 [doi]
PST - epublish
SO  - BMJ Glob Health. 2019 Aug 21;4(4):e001317. doi: 10.1136/bmjgh-2018-001317. 
      eCollection 2019.