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Background Food taxes and subsidies are one intervention to address poordiets. Price elasticity (PE) matrices are commonly used to model the change infood purchasing. Usually a PE matrix is generated in one setting then appliedto another setting with differing starting consumption and prices of foods.This violates econometric assumptions resulting in likely misestimation oftotal food consumption. We illustrate rescaling all consumption after applyinga PE matrix using a total food expenditure elasticity (TFEe, the expenditureelasticity for all food combined given the policy induced change in the totalprice of food). We use case studies of NZ$2 per 100g saturated fat (SAFA) tax,NZ$0.4 per 100g sugar tax, and a 20% fruit and vegetable (F&V) subsidy. MethodsWe estimated changes in food purchasing using a NZ PE matrix appliedconventionally, then with TFEe adjustment. Impacts were quantified for totalfood expenditure and health adjusted life years (HALYs) for the total NZpopulation alive in 2011 over the rest of their lifetime using a multistatelifetable model. Results Two NZ studies gave TFEes of 0.68 and 0.83, withinternational estimates ranging from 0.46 to 0.90. Without TFEe adjustment,total food expenditure decreased with the tax policies and increased with theF&V subsidy, implausible directions of shift given economic theory. After TFEeadjustment, HALY gains reduced by a third to a half for the two taxes andreversed from an apparent health loss to a health gain for the F&V subsidy.With TFEe adjustment, HALY gains (in 1000s) were 1,805 (95% uncertaintyinterval 1,337 to 2,340) for the SAFA tax, 1,671 (1,220 to 2,269) for the sugartax, and 953 (453 to 1,308) for the F&V subsidy. Conclusions If PE matrices areapplied in settings beyond where they were derived, additional scaling islikely required. We suggest that the TFEe is a useful scalar.

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Modelling the health impact of food taxes and subsidies with price  elasticities: the case for additional scaling of food consumption using the  total food expenditure elasticity