Cost-Effectiveness of Product Reformulation in Response to the Health Star Rating Food Labelling System in Australia

The Health Star Rating (HSR) system is a voluntary front-of-pack labelling (FoPL) initiative endorsed by the Australian government in 2014. This study examines the impact of the HSR system on pre-packaged food reformulation measured by changes in energy density between products with and without HSR. The cost-effectiveness of the HSR system was modelled using a proportional multi-state life table Markov model for the 2010 Australian population. We evaluated scenarios in which the HSR system was implemented on a voluntary and mandatory basis (i. e. , HSR uptake across 6. 7% and 100% of applicable products, respectively). The main outcomes were health-adjusted life years (HALYs), net costs, and incremental cost-effectiveness ratios (ICERs). These were calculated with accompanying 95% uncertainty intervals (95% UI). The model predicted that HSR-attributable reformulation leads to small changes corrected in mean population energy intake (voluntary: -0. 98 kJ/day; mandatory: -11. 81 kJ/day). corrected. These are likely to result in changes in mean body weight (voluntary: -0. 01 kg 95% UI: -0. 012 to -0. 006; mandatory: -0. 11 kg 95% UI: -0. 14 to -0. 07, and HALYs gained [corrected (voluntary: 4207 HALYs gained corrected 95% UI: 2438 to 6081; mandatory: 49, 949 HALYs gained 95% UI: 29, 291 to 72, 153). The HSR system corrected could be considered cost-effective relative to a willingness-to-pay threshold of A50, 000 per HALY (incremental cost effectiveness ratio for voluntary: corrected A1728 per HALY 95% UI: dominant to 10, 445 and mandatory: A4752 per HALY 95% UI: dominant to 16, 236).