摘要：Before a 1996 US regulation requiring fortification of enriched cereal-grain products with folic acid, 3 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. Because the observed decline in neural tube defect rates is greater than was forecast before fortification, the economic gains are correspondingly larger. Applying both cost–benefit and cost-effectiveness analytic techniques, we estimated that folic acid fortification is associated with annual economic benefit of $312 million to $425 million. The cost savings (net reduction in direct costs) were estimated to be in the range of $88 million to $145 million per year. ON MARCH 5, 1996, THE US Food and Drug Administration (FDA) required that manufacturers fortify enriched cereal-grain products with 140 μg of folic acid per 100 g of cereal-grain product by January 1, 1998. 1 This decision was intended to ensure that women who become pregnant would be provided access to a nutrient that can prevent a substantial proportion of neural tube defects (NTDs). 2 Before the adoption of fortification in 1996, 3 studies projected net economic benefits from fortification. 3 – 5 To date, no analysis has evaluated the costs and benefits realized by fortification. We calculated the economic impact of fortification using both cost–benefit and cost-effectiveness analytic techniques on the basis of prefortification and postfortification epidemiological data. We also discuss how observed changes in NTD rates differ from those forecast before fortification and the implication for modeling on the basis of incomplete data.
