Estimated health benefits, costs and cost-effectiveness of eliminating dietary industrial trans fatty acids in Kenya: cost-effectiveness analysis

Objectives To model the potential health gains and cost-effectiveness of a mandatory limit of industrial trans fatty acids (iTFA) in Kenyan foods. Design Multiple cohort proportional multistate life table model, incorporating existing data from the Global Burden of Disease study, pooled analyses of observational studies and peer-reviewed evidence of healthcare and policy implementation costs. Setting Kenya. Participants Adults aged >= 20 years at baseline (n=50 million). Intervention A mandatory iTFA limit (<= 2% of all fats) in the Kenyan food supply compared with a base case scenario of maintaining current trans fat intake. Main outcome measures Averted ischaemic heart disease (IHD) events and deaths, health-adjusted life years; healthcare costs; policy implementation costs; net costs; and incremental cost-effectiveness ratio. Results Over the first 10 years, the intervention was estimated to prevent similar to 1900 (95% uncertainty interval (UI): 1714; 2148) IHD deaths and similar to 17 000 (95% UI: 15 475; 19 551) IHD events, and to save similar to US$50 million (95% UI: 44; 56). The corresponding estimates over the lifespan of the model population were similar to 49 000 (95% UI: 43 775; 55 326) IHD deaths prevented, similar to 113 000 (95% UI: 100 104; 127 969) IHD events prevented and some similar to US$300 million (256; 331) saved. Policy implementation costs were estimated as similar to US$9 million over the first 10 years and similar to US$20 million over the population lifetime. The intervention was estimated to be cost saving regardless of the time horizon. Findings were robust across multiple sensitivity analyses. Conclusions Findings support policy action for a mandatory iTFA limit as a cost-saving strategy to avert IHD events and deaths in Kenya.