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首页> 外文期刊>Public Health Nutrition >Cost-effectiveness of mandatory folate fortification v. other options for the prevention of neural tube defects: results from Australia and New Zealand
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Cost-effectiveness of mandatory folate fortification v. other options for the prevention of neural tube defects: results from Australia and New Zealand

机译：强制性叶酸强化的成本效益与预防神经管缺陷的其他选择：澳大利亚和新西兰的结果

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ObjectiveTo provide input to Australian and New Zealand government decision making regarding an optimal strategy to reduce the rate of neural tube defects (NTD).DesignStandard comparative health economic evaluation techniques were employed for a set of intervention options for promoting folate/folic acid consumption in women capable of or planning a pregnancy. Evidence of effectiveness was informed by the international literature and costs were derived for Australia and New Zealand.ResultsPopulation-wide campaigns to promote supplement use and mandatory fortification were the most effective at reducing NTD, at an estimated 36 and 31 fewer cases per annum respectively for Australia and New Zealand, representing an 8 % reduction in the current annual NTD rate. Population-wide and targeted approaches to increase supplement use were cost-effective, at less than $AU 12 500 per disability-adjusted life year (DALY) averted ($US 9893, ?￡5074), as was extending voluntary fortification. Mandatory fortification was not cost-effective for New Zealand at $AU 138 500 per DALY ($US 109 609, ?￡56 216), with results uncertain for Australia, given widely varying cost estimates. Promoting a folate-rich diet was least cost-effective, with benefits restricted to impact on NTD.ConclusionsSeveral options for reducing NTD appear to fall well within accepted societal cost-effectiveness norms. All estimates are subject to considerable uncertainty, exacerbated by possible interactions between interventions, including impacts on currently effective strategies. The Australian and New Zealand governments have decided to proceed with mandatory fortification; it is hoped they will support a rigorous evaluation which will contribute to the evidence base.
机译：目的为澳大利亚和新西兰政府就降低神经管缺陷率（NTD）的最佳策略的决策提供意见.DesignStandard比较健康经济评估技术被用于一系列干预方案，以促进女性摄入叶酸/叶酸。有能力或计划怀孕。国际文献提供了有效证据，并得出了澳大利亚和新西兰的费用。结果全民推广补充剂使用和强制性强化的运动最有效地减少了NTD，估计每年分别减少36例和31例。澳洲和纽西兰，代表目前的年度新台币兑换率降低了8％。扩大全民使用补充营养的针对性方法具有成本效益，避免扩展自愿性设防，避免的每个残疾调整生命年（DALY）不到12 500澳元（9893美元，5074英镑）。在新西兰，强制性设防的成本效益不高，为每DALY 138 500澳元（109 609美元，56216英镑），鉴于成本估算差异很大，澳大利亚的结果不确定。促进富含叶酸的饮食的成本效益最低，其益处仅限于对NTD的影响。结论减少NTD的几种选择似乎完全符合公认的社会成本效益规范。所有估计数都存在很大的不确定性，干预措施之间可能的相互作用（包括对当前有效策略的影响）会加剧这种不确定性。澳大利亚和新西兰政府已决定进行强制性设防。希望他们将支持进行严格的评估，这将为证据基础做出贡献。

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