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The economic case for prevention of population vitamin D deficiency : a modelling study using data from England and Wales
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Aguiar, M., Andronis, L. (Lazaros) , Pallan, M., Högler , W. and Frew, E. (2019) The economic case for prevention of population vitamin D deficiency : a modelling study using data from England and Wales. European Journal of Clinical Nutrition . doi:10.1038/s41430-019-0486-x (In Press)
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Official URL: https://doi.org/10.1038/s41430-019-0486-x
Abstract
Background
Vitamin D deficiency (VDD) affects the health and wellbeing of millions worldwide. In high latitude countries such as the United Kingdom (UK), severe complications disproportionally affect ethnic minority groups.
Objective
To develop a decision-analytic model to estimate the cost effectiveness of population strategies to prevent VDD.
Methods
An individual-level simulation model was used to compare: (I) wheat flour fortification; (II) supplementation of at-risk groups; and (III) combined flour fortification and supplementation; with (IV) a ‘no additional intervention’ scenario, reflecting the current Vitamin D policy in the UK. We simulated the whole population over 90 years. Data from national nutrition surveys were used to estimate the risk of deficiency under the alternative scenarios. Costs incurred by the health care sector, the government, local authorities, and the general public were considered. Results were expressed as total cost and effect of each strategy, and as the cost per ‘prevented case of VDD’ and the ‘cost per Quality Adjusted Life Year (QALY)’.
Results
Wheat flour fortification was cost saving as its costs were more than offset by the cost savings from preventing VDD. The combination of supplementation and fortification was cost effective (£9.5 per QALY gained). The model estimated that wheat flour fortification alone would result in 25% fewer cases of VDD, while the combined strategy would reduce the number of cases by a further 8%.
Conclusion
There is a strong economic case for fortifying wheat flour with Vitamin D, alone or in combination with targeted vitamin D3 supplementation.
| Item Type: | Journal Article | ||||||
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| Subjects: | Q Science > QP Physiology R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Vitamin D deficiency, Vitamin D in human nutrition , Vitamin D in the body , Deficiency diseases , Ethnic groups -- Health aspects | ||||||
| Journal or Publication Title: | European Journal of Clinical Nutrition | ||||||
| Publisher: | Nature Publishing Group | ||||||
| ISSN: | 0954-3007 | ||||||
| Official Date: | 20 August 2019 | ||||||
| Dates: |
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| Date of first compliant deposit: | 7 August 2019 | ||||||
| DOI: | 10.1038/s41430-019-0486-x | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | In Press | ||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||
| RIOXX Funder/Project Grant: |
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