Cost-effectiveness of periconceptional supplementation of folic acid.
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.


METHODS
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.


METHODS
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).


CONCLUSIONS
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.
Postma
M J
MJ
Groningen 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
Londeman
J
J
Veenstra
M
M
de Walle
H E K
HE
de Jong-van den Berg
L T W
LT
D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D006801:Humans; D009436:Neural Tube Defects / Q000517:prevention & control*; D011247:Pregnancy; D016135:Spinal Dysraphism / Q000191:economics
D005492:Folic Acid