A health economic evaluation of calorie labelling in the out-of-home sector in England: A modelling study

ObjectiveIn England, since 2022, large businesses providing food in the out-of-home sector are required to display calorie information for non-prepacked food and non-alcoholic drink items. This study estimates long-term cost-effectiveness of the policy by extrapolating real-world evidence on short-term policy effects in England. DesignThe lifetime health economic impacts of calorie labelling were simulated using a microsimulation model. The analysis adopted a health systems perspective to compare the policy with a counterfactual no intervention scenario. The policy may impact calories consumed through consumer behaviour changes and through menu changes based on observations from real-world evaluations. Estimated changes to daily calorie intake are translated to weight changes. Simulated outcomes include changes in obesity, diabetes cases, cardiovascular events, quality adjusted life years (QALYs) and National Health Service costs with probabilistic sensitivity analysis to describe uncertainty. SettingA synthetic population for England aged 13-79 combining data was generated the National Diet and Nutrition Survey (2009-19) and Health Survey for England (2018, 2019). ParticipantsNone ResultsThe policy is estimated to generate lifetime cost savings were estimated to be-{pound}9.15 (95% CI - {pound}31.63, {pound}2.50), and incremental QALYs 0.0021 (95% CI-0.0008, 0.0048) per person. The incremental net benefit at {pound}20,000 per QALY was {pound}50.23 (95% CI-{pound}16.41, {pound}74.68). Greater cost-savings and QALY gains were observed in the most deprived groups. DiscussionThe out-of-home calorie labelling policy in England is uncertain but most likely cost-effective with cost-savings and marginally beneficial to health. The results are driven by expected menu changes.