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AJPH First Look, published online ahead of print Sep 29, 2005
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American Journal of Public Health, 10.2105/AJPH.2004.058859

Government, Politics, and Law

Reevaluating the Benefits of Folic Acid Fortification in the United States: Economic Analysis, Regulation, and Public Health

Scott D. Grosse 1*, Norman J. Waitzman 2, Patrick S. Romano 3, Joseph Mulinare 1

1 CDC
2 University of Utah
3 University of California at Davis

* To whom correspondence should be addressed. E-mail: sgg4{at}cdc.gov.


  Abstract

Prior to a 1996 regulation in the United States requiring fortification of enriched cereal-grain products with folic acid, three economic evaluations projected net economic benefits or cost savings of folic acid fortification resulting from the prevention of pregnancies affected by a neural tube defect (NTD). Because the observed decline in NTD rates is greater than was forecast prior to fortification, the economic gains are correspondingly larger. Applying both cost-benefit and cost-effectiveness analytic techniques, we estimate that folic acid fortification is associated with annual economic benefit of $312 million to $425 million. The cost savings (net reduction in direct costs) is estimated to be in the range of $88 million to $145 million per year.

Key Words: Government, Birth Outcomes, Nutrition/Food, Prevention




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