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Doctor-prescribed fruits and vegetables? Surprising savings for the health care system

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Healthy foods prescribed as if they were drugs: a new study published in March in PLoS Medicine suggests adopting this strategy in the United States for beneficiaries of Medicare and Medicaid-the two major federal health insurance programs-with the stated aim of reducing the risk of chronic diseases, such as cardiovascular disease or diabetes, while lowering the cost of care.

Making use of computer models, researchers at Tufts University in Boston estimated that healthy food prescriptions could prevent millions of cardiovascular events, such as heart attacks and strokes, and save billions of dollars in health care costs.

To run the simulations, the authors included people between the ages of 35 and 80 years and enrolled in Medicare or Medicaid; as part of the modeling, they used data from the three most recent surveys on the health and nutrition of U.S. citizens, as well as those produced by published studies in the literature and meta-analyses that included demographic information, dietary habits, and health care costs.

Several hypotheses were examined in the study: including an estimate of the impact that a 30 percent discount for purchasing doctor-prescribed healthy foods might have.

Already limiting prescriptions to
fruits and vegetables,
 now consumed in insufficient quantities in the U.S., it has been estimated that 1.93 million cardiovascular events could be avoided, with a total savings of $39.7 billion. When they ran the estimate assuming a wider prescription of healthy foods, they calculated that 3.28 million cardiovascular events and 120,000 cases of diabetes would be prevented and $100.2 billion would be saved.

“We found that partial coverage of the cost of purchasing fruits, vegetables, whole grains, nuts, seeds and vegetable oils would be highly cost-effective, ” said Yujin Lee, first author of the study. and would be quite similar in cost-effectiveness to prescription drugs for high cholesterol or hypertension.”

Lee Y, Mozaffarian D, Sy S, Huang Y, Liu J, Wilde PE, Abrahams-Gessel S, Jardim TSV, Gaziano TA, Micha R. Cost-effectiveness of financial incentives for improving diet and health through Medicare and Medicaid: A microsimulation study. PLoS Med. 2019 Mar 19;16(3):e1002761.

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