Avaliação de impacto orçamentário na saúde com a política de taxação de bebidas adoçadas e o desfecho sobre o diabetes tipo 2

Abstract

The incidence and prevalence of Type 2 Diabetes Mellitus (T2DM), as well as the economic impact of treating this disease, have prompted discussions on which measures could be adopted to reduce the number of cases. Among the various proposals is the implementation of an additional tax—considering the already complex existing tax structure—particularly on sugar-sweetened beverages (with the aim of reducing their consumption). The existing literature on the topic indicates a strong correlation between the consumption of sugar-sweetened beverages and the increased occurrence of the disease. Thus, the objective of this study was to estimate the public financial impact of taxing sugar-sweetened beverages and the resulting reduction in T2DM cases. To this end, we employed a health economic evaluation tool—Budget Impact Analysis—to estimate the public financial impact of adopting such a tax, taking into account price elasticity and cross-elasticity, as well as the reduction in T2DM incidence/prevalence indicators and their associated costs. The study adopted two methodological approaches: a cross-sectional descriptive study and an Economic Evaluation study using budget impact analysis. Data were drawn from three national surveys: the Household Budget Survey (POF), the National Health Survey (PNS), and the Surveillance System for Risk and Protective Factors for Chronic Diseases via Telephone Survey (Vigitel). Using the collected data, a Budget Impact Analysis model was developed to estimate reductions in mortality and morbidity indicators, always adopting the perspective of the Brazilian Unified Health System (SUS). The current taxation scenario was compared with alternative scenarios, enabling comparison of results across three tax rates—20%, 25%, and 30%—following trends observed in other countries. The findings were highly promising, indicating that such taxation could reduce the consumption of sugar-sweetened beverages as well as government expenditures on T2DM treatment. The study also discusses aspects that may lead to distortions in the potential implementation of the proposed tax, such as impacts on tax revenue and long-term economic effects.