Economic Value of Initial Implementation Activities for Proposed Ban on Sales of Over-The-Counter Diet Pills and Muscle-Building Supplements to Minors

Cynthia A Tschampl; Mary R Lee; Amanda Raffoul; Monique Santoso; S Bryn Austin

doi:10.1016/j.focus.2023.100103

Economic Value of Initial Implementation Activities for Proposed Ban on Sales of Over-The-Counter Diet Pills and Muscle-Building Supplements to Minors

AJPM Focus. 2023 Apr 29;2(3):100103. doi: 10.1016/j.focus.2023.100103. eCollection 2023 Sep.

Authors

Cynthia A Tschampl¹, Mary R Lee², Amanda Raffoul^{2

3}, Monique Santoso², S Bryn Austin^{2

3

4}

Affiliations

¹ The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts.
² Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.
³ Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
⁴ Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.

Abstract

Introduction: Over-the-counter diet pills, weight-loss supplements, and muscle-building supplements often contain harmful ingredients and are associated with eating disorder diagnoses and other negative health outcomes. This study estimated the value of state initial implementation activities, for example, regulation development, to implement a ban on the sale of dangerous over-the-counter diet pills and muscle-building supplements to minors.

Methods: We enumerated minimum, best, and maximum values for 22 inputs among 11 activities state employees may undertake if the legislation were signed into law. For employment costs, we estimated staff hours on the basis of data from 10 key informants and obtained salary ranges from a state government website. Data were collected and analyzed between September 2021 and January 2022. We calculated 95% CIs using 10,000 Monte Carlo simulations that varied inputs simultaneously and probabilistically. We conducted two sensitivity analyses using all minimum and all maximum salaries.

Results: The estimated value of state start-up activities was $47,536 (95% CI=$36,831-$57,381). Inputs with the largest impact on this estimate corresponded to combinations of the highest salary and greatest hours per task.

Conclusions: The state's one-time opportunity cost to initiate this age-restriction policy would be minimal considering potential health gains. Sensitivity analyses did not change the conclusion, especially if the state produces subregulations linked to existing law rather than new regulations.

Keywords: Eating disorders; economic evaluation; implementation; prevention; state policy; weight-loss supplements.