title: Public health impact and economic evaluation of vitamin D-fortified dairy products for fracture prevention in France.
abstract: The 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.
  
  
  
  This 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.
  
  
  
  We 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.
  
  
  
  The 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.
  
  
  
  Vitamin 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.
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. m.hiligsmann@maastrichtuniversity.nl.
authors.forename: M
authors.initials: M
authors.lastname: Hiligsmann
authors.affiliation: Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Burlet
authors.affiliation: Department of Rheumatology, Centre Hospitalier Universitaire d'Amiens, INSERM U1088, Amiens, France.
authors.forename: P
authors.initials: P
authors.lastname: Fardellone
authors.affiliation: Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia.
authors.forename: N
authors.initials: N
authors.lastname: Al-Daghri
authors.affiliation: Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Reginster
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D003611:Dairy Products / Q000191:economics*; D005260:Female; D005527:Food, Fortified / Q000191:economics*; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000178:diet therapy / Q000453:epidemiology; D058866:Osteoporotic Fractures / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D011634:Public Health / Q000191:economics* / Q000379:methods; D019057:Quality-Adjusted Life Years; D014807:Vitamin D / Q000008:administration & dosage* / Q000191:economics
chemical_list: D014807:Vitamin D
keywords: Cost-effectiveness; Dairy products; Fractures; France; Public health