New Study Finds Use of Calcium and Folic Acid Could Save $15 Billion

[Guest guest]

New Study Finds Use of Calcium and Folic Acid Could Save $15 Billion

in Health Care Costs

WASHINGTON, Sept. 22 /PRNewswire/ -- A study released today shows

that daily use of calcium would prevent 734,000 hip fractures and

save $13.9 billion in health care costs over the next five years.

Daily use of folic acid by women would prevent 600 cases of neural

tube birth defects yearly, saving $1.3 billion in lifetime medical

costs over five years. Omega-3 fatty acids, glucosamine and saw

palmetto supplements showed substantial promise for improving health

and quality of life and potentially reducing health care costs.

The study, commissioned by the Dietary Supplement Education Alliance

and conducted by The Lewin Group, included a systematic literature

review of the most rigorous scientific research available.

Key study findings include: * Calcium: The estimate of the five-year

(2005-2009) net savings in hospital, nursing facility, and physician

expenditures resulting from a reduction in the occurrence of hip

fractures among those over age 65, through daily intake of 1200 mg of

calcium with vitamin D is $13.9 billion. Approximately 734,000 hip

fractures could be avoided over the five year period. * Folic Acid:

If just 10.5 million women of childbearing age began taking 400 mcg

of folic acid daily, approximately 600 fewer babies would be born

with neural tube defects per year, saving as much as $321,853,000 as

a result. Taking into account the very low cost of the supplement,

$1.3 billion in lifetime medical costs could potentially be saved

over the next five years. * Omega-3 Fatty Acids: Recent studies have

shown that omega-3 fatty acids can have beneficial effects on

cardiovascular disease (CVD), and Lewin's review found consistent

evidence that omega-3 fatty acids help reduce deaths from CVD. The

research literature contains many promising studies concerning the

health benefits of omega-3 fatty acids for a wide number of chronic

conditions (e.g., depression, renal disease, rheumatoid arthritis and

asthma). Additional research is warranted to verify these preliminary

suggestions. * Glucosamine: Glucosamine has been shown to have anti-

inflammatory effects and is believed to repair and maintain

cartilage. Recently the use of complementary and alternative

therapies in the treatment of osteoarthritis has become more

widespread, and particular interest has focused on glucosamine. * Saw

Palmetto: Preliminary findings on the effectiveness of saw palmetto

for alleviating the symptoms of benign prostatic hyperplasia (BPH)

indicate that use of the herb yields slight to moderate improvement

in symptoms for men with this chronic urinary syndrome.

" Many studies over the years have demonstrated the positive effects

of calcium and folic acid. This report reinforces those findings by

demonstrating the cost savings that could be achieved by taking these

two supplements, " said Dobson, Ph.D., senior vice president at

The Lewin Group. " The results on omega-3 fatty acids, glucosamine and

saw palmetto were also extremely encouraging in their ability to

offset health problems and costs associated with chronic conditions. "

Noting the implications of the study, the U.S. House Committee on

Government Reform's Subcommittee on Human Rights and Wellness held a

Congressional hearing on September 22 to review the results.

Witnesses included:

* Coates, Director, Office of Dietary Supplements, National

Institutes of Health * Al Dobson, Ph.D., Senior Vice President, The

Lewin Group * Jeff Blumberg, Ph.D., Professor, Friedman School of

Nutrition Science and Policy and Associate Director of the Mayer

USDA Human Nutrition Research Center on Aging at Tufts University *

Barbara Levine, Ph.D., Associate Clinical Professor of Nutrition in

Medicine and Director of the Nutrition Information Center at Weill

Medical College of Cornell University * Elliott Balbert, Chief

Executive Officer, Natrol and President, DSEA * Marilu Henner,

actress and author

" As our country faces an ever-growing crisis in health care, it is

important to recognize the role that dietary supplements can play in

reducing our burden of disease and the costs to manage it, " said

Blumberg, professor at the Friedman School of Nutrition

Science and Policy at Tufts University.

" Many industry experts have long believed that dietary supplements

provide consumers with long-term health benefits by reducing the

incidence of debilitating health problems, and this study proves it, "

said Elliott Balbert, chief executive officer of Natrol and president

of the Dietary Supplement Education Alliance. " The findings provide

evidence to support both the cost savings and quality-of-life

benefits of these particular supplements. "

For more information about the study, visit

http://www.supplementinfo.org/.

The Lewin Group, a wholly owned subsidiary of Quintiles

Transnational, is a nationally recognized health care and human

services consulting firm in Falls Church, Va. The firm specializes in

helping public and private sector clients solve complex problems in

healthcare and human services with policy analysis, research and

consulting.

The Dietary Supplement Education Alliance is a coalition of industry

leaders whose mission is to educate consumers, media and policymakers

on the benefits of dietary supplements for optimizing health and

prevention of disease, with a focus on their safety, efficacy and

regulation. Its membership includes nutritional and dietary

supplement suppliers, manufacturers, retailers and publishers.

Improving Public Health, Reducing Health Care Costs: An Evidence-

Based Study of Five Dietary Supplements Fact Sheet

Surveys of dietary intake and physical and laboratory data reveal

that the typical American diet does not always provide a sufficient

level of nutrients to support optimal health. Some individuals may

need a vitamin and/or mineral or other supplement to meet specific

nutrient needs.(1)

The Lewin Group, Inc. was commissioned by the Dietary Supplement

Education Alliance (DSEA) to conduct an evidence-based study of five

dietary supplements. The purpose of this study is threefold: (1) to

critically review the research literature for consistency, validity

(closeness to the truth), and impact (size of the effect), (2) to

develop estimates of the potential health care expenditure savings

that could result from daily use of two of the supplements, and (3)

for supplements where there is emerging evidence, to suggest areas of

future research that would fill existing knowledge gaps. Supplements

covered in this study include (1) calcium (with Vitamin D), (2) folic

acid, (3) omega-3 fatty acids, (4) glucosamine, and (5) saw palmetto.

Lewin was asked to develop estimates of potential cost savings that

could result from daily use of those supplements for which the

highest standard of evidence exists at this time, and for which the

Food and Drug Administration (FDA) has approved health claims. Cost

estimates were developed for calcium (with Vitamin D) and folic acid,

for which there is significant scientific agreement as to the

improvement in health status and subsequent health expenditure

reduction.

Key Study Findings * Calcium: Using a Congressional Budget Office

(CBO-type) cost accounting methodology, the estimate of the five-year

(2005-2009) net savings in hospital, nursing facility, and physician

expenditures resulting from a reduction in the occurrence of hip

fractures among the over age-65 population through daily intake of

1200 mgs. of calcium with Vitamin D is $13.9 billion. Approximately

734,000 hip fractures could be avoided across the five years. See

Table 1 below. * Folic acid: The total lifetime cost of a baby with

Neural Tube Defect (NTD) in 2004 is roughly $532,000, including

direct medical costs, therapies and equipment, and special education.

Out of about 4 million live births annually, NTDs occur in one of

every 1,000 pregnancies in the U.S.(2) Of 64 million American women

who are of childbearing age, if just 10.5 million additional women

began taking 400 mcg. of folic acid on a daily basis

periconceptionally, approximately 600 babies would be born without

NTDs, saving as much as $321,853,000 as a result. Over five years,

taking into account the very low cost of the supplement, $1.3 billion

in lifetime costs could potentially be saved. Longstanding and

extensive research with supporting conclusions led the US Public

Health Service, Institute of Medicine, and Food and Drug

Administration (FDA) to establish recommendations and public health

policies relating to folic acid intake and food fortification.(3) See

Table 2 below. Table 1: Costs and Potential Savings Resulting From

Reduced Hip Fractures 2005 2006 2007 2008 2009 Total Total cost of

daily calcium for new users (adults over 65 not currently taking

calcium) and current users paid for by payer over time $575 $714 $833

$957 $1,071 $4,149 Cost offset due to avoided hospitalizations,

physician services, and SNF stays associated with reduced hip

fractures for population most at risk $3,076 $3,231 $3,393 $3,561

$3,737 $16,988 Net cost of daily calcium for adults over 65 -$2,645 -

$2,696 -$2,768 -$2,843 -$2,934 -$12,849 Premium offset (25% of

additional program spending) $144 $178 $208 $239 $268 $1,037 Total

potential cost offset from avoided health care utilization associated

with avoided hip fracture (savings) $2,646 $2,696 $2,768 $2,843

$2,934 $13,866 Table 2: Costs and Potential Savings Resulting From

Fewer Cases of NTD 2005 2006 2007 2008 2009 Total Annual Per Person

Cost of Daily Folic Acid Supplement for Women of Childbearing Age

$7.04 $7.22 $7.40 $7.58 $7.58 Number of New Users of Folic Acid (in

millions) 10.8 11.0 11.0 10.9 10.6 Gross Cost of Daily Folic Acid

Supplement for New Users among of Childbearing Age (in millions)

$76.3 $79.4 $81.6 $82.6 $82.5 $402.4 Total Lifetime Cost of NTD per

Case (in thousands) $543 $558 $572 $587 $599 Number of New Cases per

Year 4,100 4,202 4,308 4,415 4,503 21,528 Annual Lifetime Cost of New

Cases of NTD (in billions) $2.2 $2.3 $2.5 $2.6 $2.7 $12.3 Total

Savings associated with 600 Fewer NTD Cases (in millions) $326 $335

$344 $352 $359 $1,717 Net Savings of Providing 10 Million Women with

Daily Folic Acid (savings) (in millions) $250 $256 $262 $270 $264

$1,315 * Omega-3 fatty acids: Recent studies have shown that omega-3

fatty acids can have beneficial effects on cardiovascular disease

(CVD). Furthermore, FDA recently announced a qualified health claim

for EPA and DHA omega-3 fatty acids.(4) The research literature

contains many promising studies of varying quality concerning the

health benefits of omega-3 fatty acids for a wide number of chronic

conditions (e.g., depression, renal disease, rheumatoid arthritis,

and asthma) and additional research is warranted to verify these

preliminary suggestions.(5) Our review found consistent evidence that

omega-3 fatty acids help reduce deaths from CVD. In addition, there

are studies demonstrating that omega-3 fatty acids may help lower

blood pressure, may reduce the risk of re-blockage after an

angioplasty, may increase exercise capacity in people with coronary

atherosclerosis, and may reduce the risk associated with irregular

heartbeats. In March 2004, the Agency for Healthcare Research and

Quality (AHRQ) commissioned a systematic review of the literature to

assess the benefits of omega-3 fatty acids on CVD outcomes.(6) AHRQ

found that studies of omega-3 fatty acids were heterogeneous in that

they examined different forms of omega-3 fatty acids. AHRQ concluded

that focused and well-designed multicenter RCTs are now needed to

validate earlier promising results and fill in any knowledge gaps. *

Glucosamine: Glucosamine has been shown to have anti-inflammatory

effects and is believed to repair and maintain cartilage. To date,

however, clinical studies on glucosamine have not conclusively

demonstrated reductions in health service utilization that result

from these clinical benefits. In order to further advance the

science, the National Institutes of Health, National Center for

Complimentary and Alternative Medicine (NCCAM) is now supporting two

randomized double- blind studies of glucosamine. Osteoarthritis is

the most common musculoskeletal disease in the world, and its actual

cause remains unknown. In 1999, approximately 10 million adults

reported being diagnosed with osteoarthritis. The use of

complementary and alternative therapies in the treatment of

osteoarthritis has become more widespread, and particular interest

has focused on glucosamine.(6) * Saw Palmetto: Preliminary findings

of the effects of saw palmetto for alleviating the symptoms of benign

prostatic hyperplasia (BPH) indicate that use of the herb yields

slight to moderate improvement in symptoms for men with this chronic

urinary syndrome. A recently released review of clinical trials of

the herb also found that saw palmetto reduces the symptoms of BPH,

increases urinary flow, improves the quality of life and is well

tolerated, and may be considered a viable first-line therapy for

treating lower urinary tract symptoms associated with BPH.(7)

Additionally, at this time there are no known safety hazards or

contraindications to using saw palmetto with other medications.

Currently the National Center for Complementary and Alternative

Medicine (NCCAM) is conducting a randomized, double-blind, placebo

controlled clinical trial of the safety and efficacy of saw palmetto,

with careful attention to the methodological deficiencies of prior

studies (e.g., the influence of confounding variables on observed

outcomes.) (1) US Department of Agriculture, US Department of Health

and Human Services. (2000). Dietary Guidelines for Americans.

Washington DC. (2) Spina Bifida Association of America. Spina Bifida -

The Facts. Available at: http://www.sbaa.org/. Accessed April 24,

2004. (3) L, Rampersaud G, Kauwell G. Folic Acid Supplements

and Fortification Affect the Risk for Neural Tube Defects, Vascular

Disease and Cancer: Evolving Science. Journal of Nutrition. 2003;133:

1961S-1968S. (4) USDHHS: FDA. FDA Announces Qualified Health Claims

for Omega-3 Fatty Acids. FDA News -Sept 8, 2004. (5) Holub, Bruce

J., " Clinical Nutrition 4. Omega-3 Fatty Acids in Cardiovascular

Care " . JAMC, 2002; 166(5) 608-615. (6) accessed August 2, 2004. (7)

Gerber GS, Fitzpatrick JM. (2004). The role of a lipido-sterolic

extract of Serenoa repens in the management of lower urinary tract

symptoms associated with benign prostatic hyperplasia. BJU; 94(3)

August: 338-344.

Dietary Supplement Education Alliance

CONTACT: Craig Brownstein, +1-202-326-1799,

craig.brownstein@..., or Beth Mallard, +1-202-312-1084,

beth.mallard@..., both for the Dietary Supplement Education

Alliance

Web site: http://www.supplementinfo.org/