Impact of Fiscal Policy for Sugar-Sweetened Beverages on Reducing the Burden of Disease and Healthcare Costs in Brazil: A Simulation Study

Journal article

Background/Objectives: Sugar-sweetened beverage (SSB) consumption has been linked to obesity, metabolic diseases, and rising healthcare costs. This study aimed to assess the impact of a 20% excise tax on SSBs in Brazil on obesity/overweight prevalence, seven musculoskeletal and cardiovascular diseases, and related healthcare costs, with their associated impacts on health inequalities. Methods: Using 2017/2018 Brazilian Household Budget Survey data for baseline consumption and own- and cross-price elasticities for taxed beverages, we estimated changes in caloric consumption for the entire population and for lower- and upper-income quartiles. The PRIMEtime dynamic individual-level simulation model projected body weight changes, lifetime Quality-Adjusted Life-Years (QALYs), healthcare costs (discounted at 5%), and disease cases (20-year horizon). Results: A 20% excise SSB tax was projected to reduce obesity prevalence by 1.7 percentage points in men and 1.5 percentage points in women, from baseline rates of 19.8% and 23.6%, respectively. Lifetime gains were estimated at 17,878 QALYs per million men and 12,181 per million women, alongside healthcare cost savings of Int$520 million. Impacts varied by income, with smaller health gains in the lowest quartile and higher among the wealthiest. Over 20 years, the tax could avert 1784 cases of type 2 diabetes mellitus/100,000 adults (52% in men) and 1070 cases of ischemic heart disease/100,000 adults (80% in men). Conclusions: A 20% excise SSB tax in Brazil could yield large health and cost benefits. With the recent approval of the Selective Tax under Complementary Law 214/2025, Brazil has a timely opportunity to translate these projected benefits into effective public health policy.

Authors: Nucci, LB; Amies-Cull, B; Sarti, FM; Conde, WL; Enes, CC

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: MDPI
• Journal: Nutrients
• Volume: 18
• Issue: 3
• Pages: 435-435
• Article number: 435
• Publication date: 2026-01-28
• Acceptance date: 2026-01-27
• DOI: 10.3390/nu18030435
• EISSN: 2072-6643
• ISSN: 2072-6643
• Language: English
• Keywords: health policy; tax policies; non-communicable disease; economic modeling; modeling; Brazil; sugar-sweetened beverages