Economic evaluation of vitamin D and calcium food fortification for fracture prevention in Germany

Objective: The study evaluates the economic benefit of population-wide vitamin D and Ca food fortification in Germany. Design: Based on a spreadsheet model, we compared the cost of a population-wide vitamin D and Ca food-fortification programme with the potential cost savings from prevented fractures in the German female population aged 65 years and older. Setting: The annual burden of disease and the intervention cost were assessed for two scenarios: (i) no food fortification; and (ii) voluntary food fortification with 20 mu g (800 IU) of cholecalciferol (vitamin D-3) and 200 mg of Ca. The analysis considered six types of fractures: hip, clinical vertebral, humerus, wrist, other femur and pelvis. Subjects: Subgroups of the German population defined by age and sex. Results: The implementation of a vitamin D and Ca food-fortification programme in Germany would lead to annual net cost savings of (sic)315 million and prevention of 36 705 fractures in the target population. Conclusions: Vitamin D and Ca food fortification is an economically beneficial preventive health strategy that has the potential to reduce the future health burden of osteoporotic fractures in Germany. The implementation of a vitamin D and Ca food-fortification programme should be a high priority for German health policy makers because it offers substantial cost-saving potential for the German health and social care systems.