Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil

Anencephaly, encephalocele, and spina bifida are congenital neural tube defects and are the main causes of neonatal morbidity and mortality and impose a heavy economic burden on health systems. This study to estimates the direct costs of neural tube defects from the perspective of the Brazilian Mini...

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Main Authors: Viviane Belini Rodrigues, Everton Nunes da Silva, André Marques dos Santos, Leonor Maria Pacheco Santos
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9946232/?tool=EBI
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author Viviane Belini Rodrigues
Everton Nunes da Silva
André Marques dos Santos
Leonor Maria Pacheco Santos
author_facet Viviane Belini Rodrigues
Everton Nunes da Silva
André Marques dos Santos
Leonor Maria Pacheco Santos
author_sort Viviane Belini Rodrigues
collection DOAJ
description Anencephaly, encephalocele, and spina bifida are congenital neural tube defects and are the main causes of neonatal morbidity and mortality and impose a heavy economic burden on health systems. This study to estimates the direct costs of neural tube defects from the perspective of the Brazilian Ministry of Health, and the prevented cases and cost savings during the period in which mandatory folic acid fortification was in effect in the country (2010–2019). It is a top-down cost-of-illness oriented study based on the prevalence of the disorders in Brazil. Data were collected from the Brazilian Ministry of Health’s outpatient and hospital information system databases. The direct cost was estimated from the total patient-years, allocated by age and type of disorder. Prevented cases and cost savings were determined by the difference in the prevalence of the disorders in the pre- and post-fortification periods based on the total number of births and the sum of outpatient and hospital costs during the period. The total cost of outpatient and hospital services for these disorders totaled R$ 92,530,810.63 (Int$ 40,565,896.81) in 10 years; spina bifida accounted for 84.92% of the total cost. Hospital costs were expressive of all three disorders in the first year of the patient’s life. Between 2010 and 2019, mandatory folic acid fortification prevented 3,499 live births with neural tube defects and resulted in R$ 20,381,586.40 (Int$ 8,935,373.25) in hospital and outpatient cost savings. Flour fortification has proved to be a valuable strategy in preventing pregnancies with neural tube defects. Since its implementation, there has been a 30% decrease in the prevalence of neural tube defects and a 22.81% decrease associated in hospital and outpatient costs.
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spelling doaj.art-e6d69a97328b4bb3900a368db0888fb22023-02-25T05:31:30ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01182Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in BrazilViviane Belini RodriguesEverton Nunes da SilvaAndré Marques dos SantosLeonor Maria Pacheco SantosAnencephaly, encephalocele, and spina bifida are congenital neural tube defects and are the main causes of neonatal morbidity and mortality and impose a heavy economic burden on health systems. This study to estimates the direct costs of neural tube defects from the perspective of the Brazilian Ministry of Health, and the prevented cases and cost savings during the period in which mandatory folic acid fortification was in effect in the country (2010–2019). It is a top-down cost-of-illness oriented study based on the prevalence of the disorders in Brazil. Data were collected from the Brazilian Ministry of Health’s outpatient and hospital information system databases. The direct cost was estimated from the total patient-years, allocated by age and type of disorder. Prevented cases and cost savings were determined by the difference in the prevalence of the disorders in the pre- and post-fortification periods based on the total number of births and the sum of outpatient and hospital costs during the period. The total cost of outpatient and hospital services for these disorders totaled R$ 92,530,810.63 (Int$ 40,565,896.81) in 10 years; spina bifida accounted for 84.92% of the total cost. Hospital costs were expressive of all three disorders in the first year of the patient’s life. Between 2010 and 2019, mandatory folic acid fortification prevented 3,499 live births with neural tube defects and resulted in R$ 20,381,586.40 (Int$ 8,935,373.25) in hospital and outpatient cost savings. Flour fortification has proved to be a valuable strategy in preventing pregnancies with neural tube defects. Since its implementation, there has been a 30% decrease in the prevalence of neural tube defects and a 22.81% decrease associated in hospital and outpatient costs.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9946232/?tool=EBI
spellingShingle Viviane Belini Rodrigues
Everton Nunes da Silva
André Marques dos Santos
Leonor Maria Pacheco Santos
Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil
PLoS ONE
title Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil
title_full Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil
title_fullStr Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil
title_full_unstemmed Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil
title_short Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil
title_sort prevented cases of neural tube defects and cost savings after folic acid fortification of flour in brazil
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9946232/?tool=EBI
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