Should we be prescribing fruits & veggies?
Why?
Across the globe we’re experiencing rising healthcare costs and spending are increasing at an alarming rate. Diet-related conditions (diabetes, obesity, etc.) are a major contributor to that cost. An interesting idea, and something that has actually been implemented on a small scale, is “prescriptions” or incentives for eating more fruits and vegetables. The authors aimed to evaluate the implications of healthy food prescriptions in healthcare.
What?
As a part of the Food Policy Review and Intervention Cost-Effectiveness (Food-PRICE) Project (www.food-price.org), they estimated the health and economic impacts of healthy food prescriptions in the largest providers of insurance, Medicare and Medicaid.
Shockingly, over a lifetime, the fruits and vegetable incentive would potentially prevent almost 2 million cardiovascular disease (CVD) events and roughly 0.4 million CVD deaths. Which ultimately means massive savings in of an estimated $40 billion in healthcare costs.
A broader reaching, healthy food incentive would increase those numbers considerably with an estimated 3.3 million CVD cases, 0.6 million CVD deaths, and 0.1 million diabetes cases prevented and save a whapping $100 billion in healthcare costs.
Of course, cost for programs like this are naturally going to be a major concern. However, Lee et al, found that from a healthcare perspective that it’s surprisingly cost-effective.
Significance?
So, what’s the deal? The take home is this, by implementing healthy food incentives or prescriptions within large government healthcare programs we could promote healthier eating which in turn would result in increased health gains at a relatively low cost.
Also don’t forget to eat your fruits in vegetables!
Some fun figures:
Table 2. Lifetime health gains, costs, and cost-effectiveness of 30% F&V incentive and healthy food incentive programs through Medicare and Medicaid from a healthcare perspective.
Fig 2.
Estimated reductions in total (A) CVD events averted, (B) diabetes cases averted, (C) QALYs, (D) healthcare savings, (E) net costs, and (F) ICER of the 30% healthy food incentive program through Medicare and Medicaid by insurance type over 5, 10, and 20 years and lifetime. Values are shown from a healthcare perspective. Numbers indicate the values for lifetime analysis. ICERs were calculated as the change in net costs (policy costs minus healthcare savings) divided by the net change in QALYs. CVD, cardiovascular disease; ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life year.
Citation: Lee Y, Mozaffarian D, Sy S, Huang Y, Liu J, Wilde PE, et al. (2019) Cost-effectiveness of financial incentives for improving diet and health through Medicare and Medicaid: A microsimulation study. PLoS Med 16(3): e1002761. https://doi.org/10.1371/journal.pmed.1002761












