Potential impact of eliminating the tax subsidy of food and beverage television advertising directed at children and adolescents on BMI, dalys and healthcare costs in the United States

Introduction: Research indicates that food and beverage television (TV) advertising contributes to childhood obesity. The current tax treatment of advertising as an ordinary business expense serves to subsidize marketing of nutritionally-poor foods and beverages to children. Reducing exposure to TV ads by modifying the tax treatment of advertising expenses may be a promising intervention strategy. Methods: Using best available evidence, we modeled the effect of a national intervention after one year of implementation that eliminates the tax subsidy of advertising nutritionally-poor foods and beverages on TV to children ages 2-19. We adapted the Assessing Cost Effectiveness methodology to the U.S., using Medical Expenditure Panel Survey data on costs, and assessing effects on BMI and related disease rates for a simulated cohort of the 2005 U.S. population. We assumed maintenance of the BMI reduction; costs and DALYs are discounted at 3.5% annually. Results: We estimate the intervention would reduce mean per-child BMI by 0.49 (95% uncertainty interval (UI): 0.39; 0.59), avert an estimated 2.6M (95% UI: 1.3M-4.4M) Disability Adjusted Life Years (DALY) and cost an estimated $USD755,200 (95% UI: 433,000-1,151,000) per year. Reductions in BMI-related disease would result in an estimated $USD19.6 B (95% UI: 11.1-28.6B) reduction in discounted cost offsets over the life of the cohort, and save an estimated $25,900 for every dollar spent on the intervention. Discussion: Eliminating the tax subsidy of TV advertising costs for nutritionally-poor foods and beverages advertised to children and adolescents could lead to a cost saving intervention that could substantially reduce healthcare expenditures.