A systematic review of economic evaluations of health-promoting food retail-based interventions

Huong Ngoc Quynh Tran, Emma McMahon, Marj Moodie, Jaithri Ananthapavan

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    While the number of retail interventions with impacts on diet-and/or health-related outcomes is increasing, the economic evaluation literature is limited. This review investigated (i) the cost-effectiveness of health-promoting food retail interventions and (ii) key assumptions adopted in these evaluations. Methods: A systematic review of published academic studies was undertaken (CRD42020153763). Fourteen databases were searched. Eligible studies were identified, analysed, and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. 


    Eight studies that evaluated 30 retail interventions were included in the review. Common outcomes reported were cost per healthy food item purchased/served or cost per disability-adjusted life year (DALY) averted. Four studies undertook cost-utility analyses and half of these studies concluded that retail interventions were cost-effective in improving health outcomes. Most studies did not state any assumptions regarding compensatory behaviour (i.e., purchases/consumption of non-intervention foods or food purchases/consumption from non-intervention settings) and presumed that sales data were indicative of consumption.


    The cost-effectiveness of retail-based health-promoting interventions is inconclusive. Future health-promoting retail interventions should regularly include an economic evaluation which addresses key assumptions related to compensatory behaviour and the use of sales data as a proxy for consumption.

    Original languageEnglish
    Article number1356
    Pages (from-to)1-23
    Number of pages23
    JournalInternational Journal of Environmental Research and Public Health
    Issue number3
    Publication statusPublished - 1 Feb 2021


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