Abstract
INTRODUCTION: 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. METHODS: 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. POPULATION: Health outcomes related to excess weight, costs, and relative changes in obesity prevalence by income, race, and ethnicity groups in 2032 were estimated. RESULTS: 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. CONCLUSIONS: 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.