Public health impact and economic evaluation of vitamin D-fortified dairy products for fracture prevention in France
Osteoporosis International pp 1–8, Online: 18 Oct. 2016, DOI: 10.1007/s00198-016-3786-1
Agree with premise
Increasing Vitamin D in France could reduce fractures (hip, wrist, vertebrae)
Study proposed to fortify milk
- However, milk is not consumed by a large fraction of the population (lactose intolerant, etc)
- And, there is 2.5 times less vitamin D available in skim milk
Alternative ways of increasing Vitamin D levels
Fortify bread (many countries are trying this)
Fortify some bottled water (some Vitamin D is water soluble)
It is not clear that ANY Calcium supplementation is needed
Hip Fractures prevented if milk were fortified
15,087 Men, 4,413 Women
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.
Introduction: 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.
Methods: 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.
Results: 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.
Conclusion: 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.