| Folic Acid Chemoprophylaxis |
| Burden of Disease |
Prevalence1,2
3000 neural tube defect pregnancies annually in the United States.
7.6 per 10,000 live births. |
| Effectiveness |
Effectiveness of folic acid in reducing neural tube defects is 61%3
Net effectiveness of folic acid after fortification is 33%3 |
| Improvability |
Folic Acid Use4
33% of women aged 18-45 years report taking folic acid daily. |
| Cost5 |
Annual Per Person Medical Cost of Service: $9 |
| Annual Per Person Medical Cost of Savings: $1 |
| Annual Net Costs: $8 |
| % of Service Cost Recovered in Long Run: 11% |
Sources and Footnotes:
1. Spina bifida and anencephaly before and after folic acid mandate: United States, 1995-1996 and 1999-2000. MMWR Morb Mortal Wkly Rep 2004 May 7;53(17):362-5.
2. Williams LJ, Rasmussen SA, Flores A, Kirby RS, Edmonds LD. Decline in the prevalence of spina bifida and anencephaly by race/ethnicity: 1995-2002. Pediatrics 2005 Sep; 116(3):580-6.
3. Refer to the technical report on folic acid chemoprophylaxis for a fuller discussion of these data and references (availability of this report is pending publication of a related journal article).
4. Use of dietary supplements containing folic acid among women of childbearing age—United States, 2005. MMWR Morb Mortal Wkly Rep 2005 Sept 30;54(38):955-8.
5. Five notes on costs and savings: 1) Costs and savings are expressed in year 2005 dollars. 2) Costs and savings are expressed as the per person cost per year over the recommended age range to facilitate use in estimating long-term budget impact. 3) Costs and savings are not discounted to facilitate use in estimating long-term budget impact. As a result, they are not comparable to estimates that would be used in formal cost-effectiveness analysis. Services that are cost-saving from a budgetary perspective may not be cost-saving in an economic analysis that discounts future events to their present value. 4) Costs and savings reflect non-adherence and the recommended frequency of delivery. Therefore, services with less frequent intervals or with lower adherence would have a lower cost than an otherwise identical service. 5) Costs reflect both initial preventive service costs (such as screening and counseling) and necessary follow-up costs such as diagnostic testing, pharmacotherapy, and intensive interventions for weight loss.
| Prevalence of Spina Bifida After Folic Acid Fortification |
| |
|
| Racial/Ethnicity Category |
Number |
Prevalence
per 10,000 |
| Non-Hispanic white |
1249 |
3.37 |
| Non-Hispanic black |
281 |
2.90 |
| Hispanic |
704 |
4.18 |
* Spina bifida only, does not include anencephaly
Source:
Williams LJ, Rasmussen SA, Flores A, Kirby RS, Edmonds LD. Decline in the prevalence of spina bifida and anencephaly by race/ethnicity: 1995-2002. Pediatrics 2005 Sep;116(3):580-6.
|
Percentage of women aged 18-45 years
who reported taking folic acid daily |
| Population Group |
% of women reporting
consumption of folic acid |
| U.S. Population, women ages 18-45 |
|
| Total |
33% |
| Race |
|
| White |
36% |
| Nonwhite |
23% |
| Ethnicity |
|
| Hispanic |
27% |
| Non-Hispanic |
34% |
| Age group |
|
| 18-24 years |
24% |
| 25-34 years |
36% |
| 35-45 years |
37% |
| Education |
|
| Less than high school |
20% |
| High school |
31% |
| College (any) |
35% |
| Annual household income |
|
| <$25,000 |
27% |
| $25,000-$39,000 |
28% |
| $40,000-$49,000 |
37% |
| >$50,000 |
38% |
| Pregnancy Status |
|
| Pregnant |
90% |
| Not pregnant |
31% |
| |
|
|
Source:
Use of dietary supplements containing folic acid among women of childbearing age —United States, 2005. MMWR Morb Mortal Wkly Rep 2005 Sept 30;54(38):955-8.
|
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