Study protocol: combining experimental methods, econometrics and simulation modelling to determine price elasticities for studying food taxes and subsidies (The Price ExaM Study)

BackgroundThere is a need for accurate and precise food price elasticities (PE, change in consumer demand in response to change in price) to better inform policy on health-related food taxes and subsidies.Methods/DesignThe Price Experiment and Modelling (Price ExaM) study aims to: I) derive accurate and precise food PE values; II) quantify the impact of price changes on quantity and quality of discrete food group purchases and; III) model the potential health and disease impacts of a range of food taxes and subsidies. To achieve this, we will use a novel method that includes a randomised Virtual Supermarket experiment and econometric methods. Findings will be applied in simulation models to estimate population health impact (quality-adjusted life-years [QALYs]) using a multi-state life-table model. The study will consist of four sequential steps:1.We generate 5000 price sets with random price variation for all 1412 Virtual Supermarket food and beverage products. Then we add systematic price variation for foods to simulate five taxes and subsidies: a fruit and vegetable subsidy and taxes on sugar, saturated fat, salt, and sugar-sweetened beverages.2.Using an experimental design, 1000 adult New Zealand shoppers complete five household grocery shops in the Virtual Supermarket where they are randomly assigned to one of the 5000 price sets each time.3.Output data (i.e., multiple observations of price configurations and purchased amounts) are used as inputs to econometric models (using Bayesian methods) to estimate accurate PE values.4.A disease simulation model will be run with the new PE values as inputs to estimate QALYs gained and health costs saved for the five policy interventions.DiscussionThe Price ExaM study has the potential to enhance public health and economic disciplines by introducing internationally novel scientific methods to estimate accurate and precise food PE values. These values will be used to model the potential health and disease impacts of various food pricing policy options. Findings will inform policy on health-related food taxes and subsidies.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12616000122459 (registered 3 February 2016).

[1]  Richard G. Netemeyer,et al.  Price Perceptions and Consumer Shopping Behavior: A Field Study , 1993 .

[2]  T. Blakely,et al.  Estimating the cost of new public health legislation. , 2012, Bulletin of the World Health Organization.

[3]  Jennifer L. Pomeranz,et al.  The need for public policies to promote healthier food consumption: A comment on Wansink and Chandon (2014) , 2014 .

[4]  S. Jan,et al.  A systematic review of the effectiveness of food taxes and subsidies to improve diets: understanding the recent evidence. , 2014, Nutrition reviews.

[5]  B. Neal,et al.  Estimating population food and nutrient exposure: a comparison of store survey data with household panel food purchases , 2016, British Journal of Nutrition.

[6]  R. An Effectiveness of subsidies in promoting healthy food purchases and consumption: a review of field experiments , 2012, Public Health Nutrition.

[7]  Michio Obara,et al.  Food Composition Database. World-Wide-Web-based Food Composition Database System. , 1997 .

[8]  Alan D. Lopez,et al.  Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010 , 2012, The Lancet.

[9]  Cliona Ni Mhurchu,et al.  Effects of a price increase on purchases of sugar sweetened beverages. Results from a randomized controlled trial , 2014, Appetite.

[10]  M. Rayner,et al.  Taxing unhealthy food and drinks to improve health , 2012, BMJ : British Medical Journal.

[11]  J. Chalfant A Globally Flexible, Almost Ideal Demand System , 1987 .

[12]  Kristina Mohlin,et al.  Greenhouse gas taxes on animal food products: rationale, tax scheme and climate mitigation effects , 2011 .

[13]  Yannan Jiang,et al.  Using a 3D Virtual Supermarket to Measure Food Purchase Behavior: A Validation Study , 2015, Journal of medical Internet research.

[14]  I. Gren,et al.  Green consumption taxes on meat in Sweden , 2012 .

[15]  Chantal Nederkoorn,et al.  Experimental research on the relation between food price changes and food-purchasing patterns: a targeted review. , 2012, The American journal of clinical nutrition.

[16]  F. Chaloupka,et al.  Assessing the potential effectiveness of food and beverage taxes and subsidies for improving public health: a systematic review of prices, demand and body weight outcomes , 2013, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[17]  Julian M. Alston,et al.  Elasticities in AIDS Models , 1990 .

[18]  Boyd Swinburn,et al.  The effect of fiscal policy on diet, obesity and chronic disease: a systematic review. , 2010, Bulletin of the World Health Organization.

[19]  J. Lakerveld,et al.  Influence of price discounts and skill-building strategies on purchase and consumption of healthy food and beverages : outcomes of the Supermarket Healthy Eating for Life randomized controlled trial , 2016 .

[20]  Tony Blakely,et al.  Effects of price discounts and tailored nutrition education on supermarket purchases: a randomized controlled trial. , 2010, The American journal of clinical nutrition.

[21]  J. Muellbauer,et al.  An Almost Ideal Demand System , 1980 .

[22]  T. Blakely,et al.  Food Pricing Strategies, Population Diets, and Non-Communicable Disease: A Systematic Review of Simulation Studies , 2012, PLoS medicine.

[23]  P. Scarborough,et al.  Cachexia induces head and neck changes in locally advanced oropharyngeal carcinoma during definitive cisplatin and image-guided volumetric-modulated arc radiation therapy , 2016, European Journal of Clinical Nutrition.

[24]  P. van Baal,et al.  Economic evaluation and the postponement of health care costs. , 2011, Health economics.

[25]  M. D. de Boer,et al.  Price discounts significantly enhance fruit and vegetable purchases when combined with nutrition education: a randomized controlled supermarket trial. , 2013, The American journal of clinical nutrition.

[26]  P. Scarborough,et al.  Assessing the impact on chronic disease of incorporating the societal cost of greenhouse gases into the price of food: an econometric and comparative risk assessment modelling study , 2013, BMJ Open.

[27]  Tim Marsh,et al.  Changing the future of obesity: science, policy, and action , 2011, The Lancet.

[28]  M Arantxa Colchero,et al.  Beverage purchases from stores in Mexico under the excise tax on sugar sweetened beverages: observational study , 2016, British Medical Journal.

[29]  William H. Kaye-Blake,et al.  Food Prices and Consumer Demand: Differences across Income Levels and Ethnic Groups , 2013, PloS one.

[30]  B. Swinburn,et al.  The global obesity pandemic: shaped by global drivers and local environments , 2011, The Lancet.

[31]  A. Afifi,et al.  Effect of a targeted subsidy on intake of fruits and vegetables among low-income women in the Special Supplemental Nutrition Program for Women, Infants, and Children. , 2008, American journal of public health.

[32]  K. Brownell,et al.  The impact of food prices on consumption: a systematic review of research on the price elasticity of demand for food. , 2010, American journal of public health.

[33]  V. Nichèle,et al.  Taxing animal-based foods for sustainability: environmental, nutritional and social perspectives in France , 2016 .

[34]  L. Epstein,et al.  Food prices and obesity: a review. , 2014, Advances in nutrition.

[35]  T. Blakely,et al.  Health, Health Inequality, and Cost Impacts of Annual Increases in Tobacco Tax: Multistate Life Table Modeling in New Zealand , 2015, PLoS medicine.

[36]  Kenneth S. Rogoff,et al.  The real cost of food: can taxes and subsidies improve public health? , 2014, JAMA.

[37]  T. Blakely,et al.  Understanding price elasticities to inform public health research and intervention studies: key issues. , 2013, American journal of public health.

[38]  Wilma E Waterlander,et al.  Introducing taxes, subsidies or both: the effects of various food pricing strategies in a web-based supermarket randomized trial. , 2012, Preventive medicine.

[39]  S. Smed,et al.  The effect of using consumption taxes on foods to promote climate friendly diets – The case of Denmark , 2013 .

[40]  M. A. Colchero,et al.  Price elasticity of the demand for sugar sweetened beverages and soft drinks in Mexico. , 2015, Economics and human biology.