TACKLING UNHEALTHY DIETS

AND OBESITY: THE HEALTH

EFFECTS OF PREVENTION

POLICIESThe Economics of PreventionOECD – Health Division

In Any Given Moment, Obese Patients Cost More

Normal-weight patient

Obese patient (US) Obese patient (EU)90

95

100

105

110

115

Rela

tive c

ost

of

pati

ents

Source: Brunello et al., 2008Bhattacharia & Sood, 2005

The Burden of Obesity on Health Systems

US

Portugal

New Zealand

Canada

Germany

Australia

France

0% 1% 2% 3% 4% 5% 6% 7%

% of total healthcare budgetRoux & Donaldson, 2004Konnopka, Bodemann, Konig, 2011

A Comprehensive & Affordable Prevention Package to Tackle Obesity

OECD Countries Emerging Economies

Mass media campaigns Mass media campaigns

Compulsory food labelling Compulsory food labelling

Industry self-regulation of food advertising to children

Government regulation of food advertising to children

Physician-dietician counselling Fiscal measures

School-based interventions

Canada Europe Brazil China

24.03 $/cap 22.45 $/cap 0.40 $/cap 0.20 $/cap

Expectations Must Be Realistic

• Does prevention improve health?

• Does it reduce health expenditure?

• Does it improve health inequalities?

• Is it cost-effective?

Prevention Saves LivesLife Years Saved Every Year by Preventing Obesity

China

Europe

Brazil

Canada

Life years (millions)

1 LY / 19 persons.

1 LY / 8

1 LY / 20

1 / 8

Prevention Keeps HealthyYears of Life Free of Chronic Diseases

0 7 14 21 28 35 42 490

10000000

20000000

30000000

40000000

50000000

60000000

70000000

80000000

90000000

100000000

Time (years)

Mil

lion

lif

e ye

ars

0 7 14 21 28 35 42 490

10000000

20000000

30000000

40000000

50000000

60000000

70000000

80000000

90000000

100000000

Time (years)

Mil

lion

lif

e ye

ars

Europe China Brazil Canada

Cancers (lung, colorectal, breast) Cardiovascular diseases

Prevention is a Good InvestmentImpact on Health Expenditure of Preventing Obesity

0 5 10 15 20 25 30 35 40 45 50

-140

-120

-100

-80

-60

-40

-20

0

EuropeCanadaBrazilChina

Time (years)

$ /

capit

a

Cost-Effectiveness of Prevention

Brazil

China

Canada

Europe

Thousand $ / DALY

After 20 years After 50 years

0

5,00

0

10,0

00

15,0

00

20,0

00

25,0

00

30,0

00

35,0

00

Thousand $ / DALY

Key Policy Implications

• Obesity and NCDs are global economic issues

• Prices and regulations work best in emerging economies. Primary care doctors play a role in countries with stronger health systems

• Comprehensive intersectoral prevention strategies are more efficient and generate larger health gains

• We can afford to tackle obesity and prevention is good value for money

• OECD Obesity update 2014 – [The economic crisis & obesity]

• OECD/WHO-Euro/Europ. Observatory book

• OECD health working papers HWP 32, 45, 46, 48, [65], 66

• Lancet papers on NCDs and priority interventions

• WHO/OECD “Best buys” paper for the UN Summit on NCDs

OECD Work on Health Behaviours

http://www.oecd.org/health/economics-of-prevention.htm

http://www.oecd.org/health/obesity-update.htm