Economic evaluation of vitamin D and calcium food fortification for fracture prevention in Germany

Public Health Nutr. 2017 Jul;20(10):1874-1883. doi: 10.1017/S1368980015003171. Epub 2015 Nov 16.

Abstract

Objective: The study evaluates the economic benefit of population-wide vitamin D and Ca food fortification in Germany.

Design: Based on a spreadsheet model, we compared the cost of a population-wide vitamin D and Ca food-fortification programme with the potential cost savings from prevented fractures in the German female population aged 65 years and older.

Setting: The annual burden of disease and the intervention cost were assessed for two scenarios: (i) no food fortification; and (ii) voluntary food fortification with 20 µg (800 IU) of cholecalciferol (vitamin D3) and 200 mg of Ca. The analysis considered six types of fractures: hip, clinical vertebral, humerus, wrist, other femur and pelvis.

Subjects: Subgroups of the German population defined by age and sex.

Results: The implementation of a vitamin D and Ca food-fortification programme in Germany would lead to annual net cost savings of €315 million and prevention of 36 705 fractures in the target population.

Conclusions: Vitamin D and Ca food fortification is an economically beneficial preventive health strategy that has the potential to reduce the future health burden of osteoporotic fractures in Germany. The implementation of a vitamin D and Ca food-fortification programme should be a high priority for German health policy makers because it offers substantial cost-saving potential for the German health and social care systems.

Keywords: Cost savings; Deficiency; Economic evaluation; Food fortification; Fracture prevention; Nutrition policy; Vitamin D.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Calcium / administration & dosage*
  • Calcium / economics
  • Cost-Benefit Analysis / economics*
  • Cost-Benefit Analysis / statistics & numerical data
  • Dietary Supplements / economics*
  • Dietary Supplements / statistics & numerical data
  • Female
  • Food, Fortified / economics*
  • Food, Fortified / statistics & numerical data
  • Fractures, Bone / economics
  • Fractures, Bone / prevention & control*
  • Germany
  • Humans
  • Program Evaluation / economics
  • Program Evaluation / methods
  • Program Evaluation / statistics & numerical data
  • Vitamin D / administration & dosage*
  • Vitamin D / economics
  • Vitamins / administration & dosage
  • Vitamins / economics

Substances

  • Vitamins
  • Vitamin D
  • Calcium