Germany's potential billions in savings and health gains with sugar-sweetened beverage tax (2024)

Germany's potential billions in savings and health gains with sugar-sweetened beverage tax (1)By Pooja Toshniwal PahariaNov 26 2023Reviewed by Susha Cheriyedath, M.Sc.

In a recent study published in the journal PLoS Medicine, researchers estimated the economic and health impact of sugar-sweetened beverage (SSB) taxes in Germany.

The World Health Organization (WHO) recommends taxes on sugary soft drinks (SSBs) to reduce cardiometabolic disorders by increasing costs or by industry reforms to reduce sugar content. However, Germany has no SSB tax and is preparing a new strategy for food policy until 2050. The potential long-term economic and health impacts of taxation on SSBs in Germany are unclear.

Germany's potential billions in savings and health gains with sugar-sweetened beverage tax (2)Study: Projected health and economic impacts of sugar-sweetened beverage taxation in Germany: A cross-validation modelling study. Image Credit:TassaneeT/ Shutterstock

About the study

In the present cross-validation modeling study, researchers used established epidemiological evidence and national data to develop the first population health microsimulation model for Germany (IMPACTNCD), which was applied to predict the economic and health implications of different SSB taxation scenarios.

The researchers developed a microsimulation model based on the United Kingdom (UK) IMPACTNCD framework to study the impact of sugar-sweetened beverage taxation on dietary exposure, body mass index (BMI), cardiometabolic diseases, and related economic costs among Germans. The team modeled the Germans aged between 30 and 90 years over 20 years (between 2023 and 2043) and performed an economic evaluation from societal and healthcare perspectives.

Three scenarios were evaluated using the model: (i) a 20% ad valorem tax on SSBs based on international scientific consensus recommendations (the ad valorem tax scenario); (ii) a 20% ad valorem tax on SSBs and fruit juice (the extended ad valorem tax scenario); and (iii) a 30% reformulation of SSBs towards lower sugar content (the tiered tax scenario). The team predicted alterations in sugar intake and related changes in body weight for each scenario. They also estimated financial impacts and the quality-adjusted life years (QALYs) from health and societal perspectives.

All scenarios were re-estimated using only BMI-mediated effects, and the results were cross-validated with the PRIMEtime cohort model. The researchers constructed a synthetic German population to simulate the population-level impact of the policy scenarios. They used data on BMI and sugar-sweetened beverage and fruit juice intake from various studies, national data on the epidemiology of stroke, coronary heart disease (CHD), and type 2 diabetes mellitus (T2DM), and information on death counts, population count estimates, and projections by age and sex.

The team used generalized additive models for location, shape, and scale (GAMLSS) to estimate exposure distributions conditional on age and sex. By analyzing the German household consumption survey data, they estimated de novo uncompensated price elasticities for beverage categories with an almost ideal demand system. The own-price elasticity estimates for SSBs and fruit juices were −0.96 and −1.1, respectively, whereas their cross-price elasticity was 0.05.

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Based on a recent meta-analysis, the team assumed a tax pass-through of 82%. The researchers primarily utilized anthropometric and dietary data from the KORA S4 cohort study and its two follow-ups, F4 and FF4 (1999 to 2014), which were supposed to be population representative of the Augsburg area in southern Germany. The SSB category included uncaffeinated soft drinks and fruit drinks with added sugars such as caloric sweeteners. The fruit juice category included 100% fruit juices, nectars, or other juice types that may contain added sugars.

Results

A 20% tax on sugar-sweetened beverages could decrease sugar consumption among German adults by 1.0 grams per day; expanding the 20% tax to fruit juices could lower sugar intake by 5.9 grams per day; and the tiered tax scenario leading to a 30% reduction in SSB sugar content via reformulation could reduce sugar intake by 2.3 grams per day.

Further, SSB taxation for Germans could avert or delay 132,100-244,100 T2DM cases, with a gain of 106,000-192,300 QALYs and a saving of €10-€16 billion from a societal perspective between 2023 and 2043. The tiered tax scenario showed the most profound effects. In absolute terms, the health impacts over the long run largely depended on the significance of the direct, body mass index-independent cardiovascular and metabolic effects of sugar-sweetened beverages.

The effects of 20% taxation on sugar-sweetened beverages were more profound when extending taxes to fruit juices (252,400 quality-adjusted life years gained; €12 billion saved); however, excluding the direct health implications of sugar-sweetened beverages decreased the effects of taxation. The cross-validation analysis using PRIMEtime data yielded similar findings. The limitations were uncertainties in epidemiological evidence and the absence of product-level information.

Overall, the study findings showed that applying taxes to sugar-sweetened beverages in Germany could significantly reduce non-communicable diseases and societal costs, in line with international modeling studies. This strategy would more profoundly impact population health and the economy than the ad valorem tax, which drives price increases. The modeled scenarios would enhance public health and save societal expenditures by preventing the development of cardiometabolic diseases. Future research should include children and adolescents and assess temporal patterns and health implications other than cardiovascular disease and type 2 diabetes mellitus.

Journal reference:

Germany's potential billions in savings and health gains with sugar-sweetened beverage tax (2024)

FAQs

Germany's potential billions in savings and health gains with sugar-sweetened beverage tax? ›

Taxation of SSBs in Germany could prevent or postpone 132,100 to 244,100 cases of type 2 diabetes, gain 106,000 to 192,300 quality-adjusted life years (QALYs) and save €10.8 to €16.0 billion in societal cost from 2023 to 2043 with the highest impacts estimated for tiered taxation.

What are the benefits of taxing sugar sweetened beverages? ›

Reduces the rates of costly and preventable chronic diseases. Increases awareness about the harmful effects of sugary drinks. Discourages consumption of sugary drinks by raising their prices.

What are the arguments against the tax on sugary drinks? ›

Taxes on drink volume or sales are less efficient because they do not reflect the wide variation in sugar content among sweetened beverages. For a given level of overall taxation, taxes on volume or price do too little to discourage consumption of high-sugar drinks and too much to discourage relatively low-sugar ones.

What does the study say about taxing sugar levels in soda could prevent 2 million us cases of diabetes and cardiovascular disease? ›

Taxing sugar levels in soda could prevent 2 million US cases of diabetes and cardiovascular disease, study says. Cities, states and nations have been turning to sugar taxes as a potential way to improve public health in their communities, but the jury has been out on how best to implement the fine.

Is there sugar tax in Germany? ›

The World Health Organization (WHO) recommends taxes on sugary soft drinks (SSBs) to reduce cardiometabolic disorders by increasing costs or by industry reforms to reduce sugar content. However, Germany has no SSB tax and is preparing a new strategy for food policy until 2050.

How does the sugar tax help society? ›

The tax is projected to decrease sugary drink consumption among California residents, prevent nearly 200,000 cases of obesity, and save more than 1.8 billion dollars in health care costs. People who consume sugary drinks are expected to spend less on these drinks with the tax in place.

How does the soda tax improve health? ›

A new study shows taxes on sugary beverages like soda reduce demand and are likely to improve public health. Soda is the No. 1 source of added sugar in the American diet.

Why should the government not tax sugary drinks? ›

Soda tax opponents usually cite regressivity as the major reason for their disapproval. Regressive taxes take a larger percentage of income from low-income taxpayers than from high-income taxpayers. Because lower income households spend a higher portion of their income on soda, they pay disproportionally more taxes.

What is the problem with beverages and sugar? ›

Frequently drinking sugar-sweetened beverages is associated with weight gain, obesity, type 2 diabetes, heart disease, kidney diseases, non-alcoholic liver disease, tooth decay and cavities, and gout, a type of arthritis.

Why should sugary drinks be banned? ›

Sugar sweetened beverages are associated with obesity and many related health risks such as type 2 diabetes. New research also suggests that consuming sugar sweetened beverages also amplifies the genetic risk of obesity.

Does sugar clog arteries? ›

When you consume excess sugar, the extra calories are stored as triglycerides, and high levels of triglycerides are a major risk factor for heart disease. LDL cholesterol. Foods high in sugar have been linked to high levels of “bad” cholesterol, which is known to clog the arteries that supply oxygen to the heart.

How much more evidence that soda taxes cut soda drinking? ›

Five U.S. cities which imposed taxes on sugary drinks saw prices rise and sales fall by 33%, according to a new study. Sales of sugary drinks fell dramatically across five U.S. cities, after they implemented taxes targeting those drinks – and those changes were sustained over time.

Why soda tax is ineffective? ›

So why have these taxes been so ineffective? First, it is often assumed that taxes will all be passed on to consumers. This rarely happens. Companies will absorb taxes if passing them along would result in sales decreases that lead to greater financial losses.

Why is the tax in Germany so high? ›

They are the government's most important source of revenue, which is used to fund spending for the common good – such as social security, education, healthcare and transport infrastructure. The German tax system is based on ability to pay, transparency and fairness.

Where does Germany import sugar from? ›

Germany: $4.85 billion

In 2023, Germany imports the most sugar from Belgium accounting for $515.91 million.

Are taxes low in Germany? ›

In Germany, the average single worker faced a net average tax rate of 37.4% in 2023, compared with the OECD average of 24.9%. In other words, in Germany the take-home pay of an average single worker, after tax and benefits, was 62.6% of their gross wage, compared with the OECD average of 75.1%.

What are the benefits of limiting the consumption of sugar sweetened beverages? ›

Additionally, drinking sugary beverages is associated with developing kidney disease, non-alcoholic fatty liver disease, and gout, a type of arthritis. Cutting back on sugary drinks can reduce your risk of developing these chronic diseases and help you lead a healthier life.

What is the impact of a sugar sweetened beverages tax on oral health and costs of dental care in Australia? ›

Results: Our results indicate that in the adult population an ad valorem tax of 20% would lead to a reduction in decayed, missing and filled teeth (DMFT) by 3.9 million units over 10 years, resulting in cost savings of A$666 million.

Why do taxes on sugary drinks by the World Health Organization? ›

Research shows that taxing alcohol and SSBs helps cut down use of these products and gives companies a reason to make healthier products. While at the same time tax on these products help prevent injuries and noncommunicable diseases such as cancers, diabetes and heart diseases.

Should taxes be raised on sugar drinks to help fight obesity? ›

A new analysis led by a researcher from Harvard T.H. Chan School of Public Health suggests taxing sweetened beverages by the amount of sugar they contain rather than by liquid volume, as some cities currently do.

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