Public health impact and economic evaluation of vitamin D-fortified dairy products for fracture prevention in France

Abstract

SummaryThe recommended intake of vitamin D-fortified dairy products can substantially decrease the burden of osteoporotic fractures and seems an economically beneficial strategy in the general French population aged over 60 years.IntroductionThis study aims to assess the public health and economic impact of vitamin D-fortified dairy products in the general French population aged over 60 years.MethodsWe estimated the lifetime health impacts expressed in number of fractures prevented, life years gained, and quality-adjusted life years (QALY) gained of the recommended intake of dairy products in the general French population over 60 years for 1 year (2015). A validated microsimulation model was used to simulate three age cohorts for both women and men (60–69, 70–79, and >80 years). The incremental cost per QALY gained of vitamin D-fortified dairy products compared to the absence of appropriate intake was estimated in different populations, assuming the cost of two dairy products per day in base case.ResultsThe total lifetime number of fractures decreased by 64,932 for the recommended intake of dairy products in the general population over 60 years, of which 46,472 and 18,460 occurred in women and men, respectively. In particular, 15,087 and 4413 hip fractures could be prevented in women and men. Vitamin D-fortified dairy products also resulted in 32,569 QALYs and 29,169 life years gained. The cost per QALY gained of appropriate dairy intake was estimated at €58,244 and fall below a threshold of €30,000 per QALY gained in women over 70 years and in men over 80 years.ConclusionVitamin D-fortified dairy products have the potential to substantially reduce the burden of osteoporotic fractures in France and seem an economically beneficial strategy, especially in the general population aged above 70 years.

Food Fortification as a Preventive Factor of Micronutrient Deficiency

“…Анализ эффективности обогащения, проведенный во Франции, показал, что потребление двух молочных продуктов, обогащенных витамином D, может привести к значительному снижению экономических затрат на лечение переломов у женщин старше 60 лет и у мужчин старше 70 лет [28].…”

The projected public health and economic impact of vitamin D fortified dairy products for fracture prevention in France

“…In recent years, several economic evaluations have been conducted to assess the public health and economic impact of anti-osteoporosis medications [4]. With the increasing recognizing of the value of calcium and vitamin D to protect bone health, several studies have assessed the public health and economic impact of vitamin D fortified dairy products [5][6][7][8][9]. Dairy products are rich in nutrients that are essential for good bone health, including calcium, vitamin D, protein, potassium, phosphorus, and other micronutrients and macronutrients that are known to positively influence bone and muscle homeostasis, hence fracture risk.…”

“…In a recent French study, we estimated that the recommended intake of dairy products in the general French population over 60 years during 1 year would lead to a lifetime reduction of 64,932 fractures and of 32,569 quality-adjusted life years (QALY) gained. The cost per QALY gained of appropriate dairy intake compared to no appropriate intake was estimated at €58,244 [7].…”

“…In this study, we therefore aimed to estimate the projected public health and economic impact of vitamin D fortified dairy products for fracture prevention in the French general population aged over 60 years. Using a microsimulation model that was specifically designed to assess the public health and economic burden of vitamin D fortified dairy products in France [7], projections for the years 2020, 2030, 2040, 2050, and 2060 were conducted in this study.…”

Ultraviolet Irradiation to Enrich Foods With Vitamin

“…В результате технологически обогащенные жидкие молочные продукты вносят в общее потребление 28-63 % витамина D (23). Доказана эффективность такого обогащения: сообщается о снижении числа остеопоротических переломов (24,25) у населения и экономической выгоде (26,27). Альтернативный способ повышения содержания витамина D в сельскохозяйственной продукции -облучение ультрафиолетовым светом (УФ-облучение).…”