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. Author manuscript; available in PMC: 2013 Dec 9.
Published in final edited form as: Public Health Nutr. 2008 Jul 1;12(4):10.1017/S1368980008002565. doi: 10.1017/S1368980008002565

Table 5.

QALYs and costs (millions of dollars) associated with folic acid fortification, using alternative NTD and MI dose-response functionsa

Annual QALY Gains
Strategyb NTDs MIs CC B-12 Net QALY
gain		 Annual net costs
No fortification 0 0 0 0 0 $0
140 mcg/100 g 15,842 114,532 17,402 −5 147,770 −$2,154
350 mcg/100 g 28,445 193,475 57,403 −57 279,267 −$3,958
700 mcg/100 g 33,268 224,325 112,146 −254 369,485 −$5,078
a

NTD dose-response function assumes the following relative risks of NTD-affected pregnancy: 0.36; 0.50; and 0.65 for maternal folate intake of >400, 301-400, and 201-300 micrograms (mcg) per day, respectively, compared to ≤200 mcg/day. MI dose-response function assumes the following relative risks of MI: 0.59; 0.63; and 0.70 for folate intake of >400, 301-400, and 201-300 micrograms (mcg) per day, respectively, compared to ≤200 mcg/day.

b

Strategies labeled by amount of fortification in mcg of folic acid added per 100 g of enriched grain product.

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