Table 3.
Annual QALYs and costs associated with U.S. folic acid fortification, by fortification strategy and outcome
| Strategya | NTDs | MIs | CC | B-12 | Net | |
|---|---|---|---|---|---|---|
| Events averted | ||||||
| 140 mcg/100 g | 182 | 16,862 | 6,261 | −15 | 23,289 | |
| 350 mcg/100 g | 883 | 53,011 | 20,110 | −184 | 73,821 | |
| 700 mcg/100 g | 1,423 | 88,172 | 38,805 | −820 | 127,579 | |
| QALYs gained | ||||||
| 140 mcg/100 g | 3,436 | 35,458 | 17,402 | −5 | 56,291 | |
| 350 mcg/100 g | 16,697 | 111,121 | 57,403 | −57 | 185,165 | |
| 700 mcg/100 g | 26,899 | 184,149 | 112,146 | −254 | 322,940 | |
| Costs incurred (millions of dollars) b |
Fortification
costs |
Net costs | ||||
| 140 mcg/100 g | −$33.7 | −$550.8 | −$199.4 | $0.1 | $3.3 | −$780.5 |
| 350 mcg/100 g | −$163.8 | −$1,731.5 | −$640.4 | $1.0 | $6.0 | −$2,528.8 |
| 700 mcg/100 g | −$263.9 | −$2,880.0 | −$1,235.7 | $4.3 | $10.5 | −$4,364.8 |
a
Strategies labeled by amount of fortification in mcg of folic acid added per 100 g of enriched grain product.
b
Disease-specific costs do not include fortification costs.
QALYs, quality-adjusted-life-years; NTDs, neural tube defects; MIs, myocardial infarctions; CC, colon cancer; B-12, Vitamin B-12 masking; mcg, micrograms; g, grams