Healthy Food Rx Could Be Cost-Effective for Medicare, Medicaid
Coverage for healthy food could improve health, reduce costs, and pay for itself after five years
WEDNESDAY, March 20, 2019 (Pharmacist's Briefing) -- Economic incentives for healthier foods through Medicare and Medicaid could generate substantial health gains and be highly cost-effective, according to a study published online March 19 in PLOS Medicine.
Yujin Lee, Ph.D., from Tufts University in Boston, and colleagues developed a microsimulation model to estimate cardiovascular disease (CVD) and diabetes cases prevented, quality-adjusted life-years (QALYs), health-related costs (formal health care, informal health care, and lost-productivity costs), and incremental cost-effectiveness ratios (ICERs) for two policy scenarios for adults within Medicare and Medicaid: a 30 percent subsidy on fruits and vegetables (F&V incentive) and a 30 percent subsidy on broader healthful foods including F&V, whole grains, nuts/seeds, seafood, and plant oils (healthy food incentive). Health and cost impacts were simulated for current Medicare and Medicaid participants (82 million adults aged 35 to 80 years old).
The researchers found that the F&V incentive prevented an estimated 1.93 million CVD events, gained 4.64 million QALYs, and saved $39.7 billion in formal health care costs, while the healthy food incentive prevented 3.28 million CVD events and 0.12 million diabetes events, gained 8.4 million QALYs, and saved $100.2 billion in formal health care costs. Both scenarios were cost-effective at five years and beyond, with lifetime ICERs of $18,184/QALY (F&V incentive) and $13,194/QALY (healthy food incentive). Including informal health care costs and lost productivity from a societal perspective, respective ICERs were $14,576/QALY and $9,497/QALY. Results were robust when analyses assessed food subsidy levels (20 and 50 percent) and beneficiary characteristics (e.g., age, race/ethnicity, education, income).
"These new findings support the concept of Food is Medicine: That innovative programs to encourage and reimburse healthy eating can and should be integrated into the health care system," a coauthor said in a statement.
Several authors disclosed financial ties to food, nutrition, and pharmaceutical companies.