Introduction
In recent years, healthy food pricing incentives have emerged as a promising approach for increasing the affordability of healthy foods. Incentives reduce the cost to consumers of healthy foods through subsidies, discounts, rebates and matches. Numerous reviews have demonstrated that incentives increase consumption, purchases and sales of healthy foods, especially of fruits and vegetables.
While the evidence is clear that pricing incentives work, the most recent reviews are current only through 2017 and it remains unknown what specific attributes and program design features of healthy food pricing incentives make them effective in increasing healthy food consumption. We therefore conducted a systematic literature review to update prior reviews by summarizing current knowledge and describing which attributes of incentive interventions may be associated with greater effectiveness. We identified 3,793 distinct articles, selected 149 articles for full-text review, and included 29 studies described in 33 articles in the review
We found moderate to good quality evidence supporting the use of pricing incentives to increase consumption or purchases of fruits and vegetables. Our review suggests that providing the incentive electronically on more than one occasion for 24 weeks or longer, including a broader selection of healthy foods (e.g. all fruit and vegetable types rather than fresh only or additional types of healthy foods) and allowing redemption in stores may be features associated with successful programs. More information on how best to design pricing incentive programs is needed.