McKinsey and obesity – the economics of different interventions 

McKinsey and obesity – the economics of different interventions 
McKinsey are everywhere. They are even advising us about obesity policy now. 
http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/how-the-world-could-better-fight-obesity
To be fair, this is an excellent report.
Neatly sets out the cost effectiveness and impact of a wide range of obesity policy interventions.
There is a powerful chart on the opening page showing the distinction between population impact and cost effectiveness.

I can’t paste it into the blog (on account of my technical ineptitude) so you’ll have to look at the report yourself to see
http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/how-the-world-could-better-fight-obesity

https://pbs.twimg.com/media/CcIDnccVAAEGkpN.jpg
Both cost effectiveness and population impact are important. But we often focus on one of these two metrics, we should consider both.

But even a spectacularly cost effective or cost saving intervention is neither use nor ornament if the population impact is tiny – this is the problem of scale. 

Prof Bevan from LSE describes this as one of the fundamental problems of the HTA mindset – HTAs tell us about the cost effectiveness of a tiny part of a problem / pathway or an issue (the increment) but nothing about whether we are optimally using resources in that whole area. 

This is where tools like PBMA, STAR and similar come in.

Back to the report.

I think it’s excellent. It isn’t comprehensive and there are some notable exceptions that don’t appear to be included in the analysis

Lack of data, different perspectives, other reasons?
I was asked this question on Twitter
“If sugar tax is so low in terms of DALYs, why are the medics and NGOs so keen on it?”
It was an interesting question. Worth a thought.

I responded emmediately, here is a more considered response.
1. must get into detail of the interventions to understand the headlines
Like all league table type of charts, really important to understand what intervention was modelled, how, what comparators, assumptions, time horizons etc

This has a huge bearing on the results of the modelling.

So don’t just look at the pretty picture on the front page, engage with the detail!

2. think who McKinsey other customers are (sugar industry I’d bet) and how this influences what’s in report
Self explanatory, but McKinsey isn’t going to go out of its way to upset other corporates on whom it relies for income. Don’t bite the hand that feeds you etc. 

Back to 1 – the issue of how the modelling is done etc

Thanks @mpntod 

3. The PHE report also said more powerful interventions than tax

There are.

Don’t get fixated on just one intervention

PHE report was clear in this respect

I agree

4. that said – to answer the question directly, tax is symbolic of political will, totemic, easy to see and measure (compare to “portion sizes”) etc

Postcript

A fifth was added – not by me “a media-savvy Mockney chef- restaurateur (whose recipes are crammed with sugar) saw a self-publicity opportunity?”
I disagree with this

All up, interesting report

Go read it

Interesting question that was asked.

 

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