Prevention of the Wernicke-Korsakoff syndrome: a cost-benefit analysis

The Wernicke-Korsakoff syndrome is a thiamine-deficiency disorder occurring primarily among alcoholics. To determine the economic feasibility of preventing this disease by fortification of alcoholic beverages with thiamine, we compared the cost of fortification with the cost of institutionalizing alcoholics with the disorder. The estimated annual incidence of institutionalization is eight per million adult population. The cost of long-term institutionalization, discounted to present value, is $70 million per year. The cost of adequately fortifying alcoholic beverages is estimated to range from $3 million per year if allithiamines are used, to as much as $17 million per year if thiamine hydrochloride proves necessary. Thus, the cost-benefit ratio may range from 1:23 to 1:4. It is economically advantageous to prevent the Wernicke-Korsakoff syndrome by fortification of alcoholic beverages with thiamine. The stability, safety and marketability of thiamine and the allithiamines in alcoholic beverages should be studied further.