Health Care Cost Reduction – Study Findings
A clear need for focusing time and money in the area of dietary supplements is supported by two key findings in the field. Surveys of dietary intake and physical and laboratory data reveal that the typical American diet does not always provide a sufficient level of vitamins and/or minerals (Dept. of Health and Human Services, HHS). In addition, the Nutrition and Your Health: Dietary Guidelines for Americans acknowledges that some Americans may need a vitamin and/or mineral supplement to meet specific nutrient needs. (Department of Agriculture, USDA).
Previous studies sponsored by DSEA found that existing evidence-based research indicated positive health effects:
- Calcium and vitamin D reduce bone loss and/or osteoporosis, especially among post-menopausal women
- Folic acid reduces the occurrence of neural tube defects (NTDs) if women consume the supplement before they become pregnant, and continue to do so in the early stages of pregnancy
- Omega-3 fatty acids reduce the relative risk of coronary heart disease (CHD)
- Lutein with zeaxanthin reduces the risk of age-related macular degeneration (AMD)
Calcium with Vitamin D: In 2003, there were 309,500 hospitalizations for hip fracture among older Americans.16 We found considerable evidence supporting the association between taking 1200 mg of calcium with vitamin D, reduced bone loss, and fewer hip fractures in elderly people. This results not only in a reduction in the cost of hospitalization to repair the hip, but also a reduction in the post-acute care in a skilled nursing facility and associated physician costs. We estimated that cost offsets could result from the potential avoidance of approximately 776,000 hospitalizations for hip fractures over five years, and avoidance of admissions to skilled nursing facilities for some proportion of these (approximately 25%). The five year (2008-2012) estimated cost effect to Medicare associated with avoided hip fractures is approximately $16.1 billion. See Table 1.
Omega-3 fatty acids: There are approximately 1.5 million hospital discharges of aged Medicare beneficiaries each year for coronary heart disease (CHD), approximately 7.6 million over five years (2008-2012). Based on the literature, we assumed a 15% reduction in CHD among the subset of individuals who began taking omega-3 fatty acids over the period (approximately 54,000 in 2008). Based upon the recent publicity of the health benefits of omega-3, we assumed a 25% take up rate in 2008 ramping up to 41% of potential new users in 2012. We estimate that over five years approximately 374,301 hospitalizations for coronary heart disease (CHD) could be avoided through daily use of 1800 mg.17 The cost effect to Medicare resulting from reduced hospital and physician expenditures could be approximately $3.2 billion. See Table 2.
Lutein with Zeaxanthin: Because the loss of central vision is widely considered to be a determinant of dependency in over-65 adults, the cost estimate is comprised of potential avoidance of the transition to dependence associated with the relative risk of AMD. We assumed a 10% take up rate in 2008, ramping up to a 23% rate in 2012. We further assumed (based on the literature) that 39% of individuals would experience increased macular pigment density and 43% of those individuals would experience a reduced risk of AMD, or about 500,000 per year. About 1.1% of new individuals require dependent care in a nursing facility and 3.3% in the community each year or about 25,000 individuals in 2008. Avoidance over five years (2008-2012) of a transition to dependence by 190,927 individuals taking 6-10 mg. of lutein with zeaxanthin daily could result in $3.6 billion in savings. See Table 3 below.
Folic Acid: Of the approximately 44 million American women of childbearing age who are currently not taking folic acid, if only 11.3 million began taking 400 mcg. of folic acid on a daily basis periconceptually, as many as 600 babies could be born without neural tube defects (NTDs), saving as much as $344,700,000 in lifetime healthcare costs for these children. Over five years, (2008-2012) approximately $1.4 billion could potentially be saved. See Table 4.
16 National Center for Health Statistics, 2006.
17 The Food and Drug Administration (FDA) recommends that consumers not exceed 3,000 mg. per day of EPA and DHA omega-3 fatty acids, with no more than 2,000 mg. per day from a supplement.