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Published on: June 28, 2024
Cost-effectiveness of periconceptional supplementation of folic acid
M J Postma1, J Londeman, M Veenstra
1Groningen University, Institute for Drug Exploration/University of Groningen Research Institute of Pharmacy (GUIDE/GRIP), Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. m.postma@farm.rug.nl
Insights
Periconceptional folic acid supplementation is cost-effective for preventing neural tube defects (NTDs) like spina bifida. This approach offers significant value, justifying increased public health efforts and education for expectant mothers.
Area of Science:
- Reproductive health
- Public health
- Pharmacoeconomics
Background:
- Folic acid supplementation before and during early pregnancy can prevent neural tube defects (NTDs), including spina bifida.
- NTDs are serious congenital malformations affecting newborns.
Purpose of the Study:
- To determine the cost-effectiveness of periconceptional folic acid supplementation.
- Utilizing a pharmacoeconomic model for accurate estimation.
Main Methods:
- Estimating NTD probabilities and risk reduction from folic acid supplementation.
- Calculating lifetime care costs for spina bifida patients.
- Utilizing Dutch registries and international literature for data.
Main Results:
- The base case cost-effectiveness was estimated at NLG 3900 per discounted life-year gained.
- Sensitivity analysis indicated cost-effectiveness generally remained below NLG 10,000.
- This demonstrates a favorable economic return on investment.
Conclusions:
- Periconceptional folic acid supplementation presents a favorable cost-effectiveness profile.
- The findings support increased promotion of folic acid intake before pregnancy.
- Healthcare professionals, including pharmacists, should educate women on supplementation benefits.
Background:
Supplementation of folic acid prior to and in the beginning of pregnancy may prevent neural tube defects (NTDs) in newborns--such as spina bifida--and possibly other congenital malformations.
Objective:
To estimate cost effectiveness of periconceptional supplementation of folic acid using pharmaco-economic model calculation.
Method:
Probabilities for NTDs, risk reductions through periconceptional supplementation of folic acid and lifetime costs of care for children with spina bifida were estimated using Dutch registrations and international literature.
Main Outcome Measure:
Cost effectiveness was expressed in net costs per discounted life-year gained. Cost effectiveness was calculated in the baseline and in sensitivity analysis.
Results:
Estimated cost effectiveness of periconceptional supplementation of folic acid amounts to NLG 3900 ([symbol: see text] 1800) in the base case. In sensitivity analysis cost effectiveness mostly remains below NLG 10,000 ([symbol: see text] 4500).
Conclusion:
Periconceptional supplementation of folic acid shows a favorable cost effectiveness. From pharmaco-economic point of view this justifies further stimulation of folic-acid supplementation prior to pregnancy. This can be done through targeted education by health-care workers, such as pharmacists.
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