Vitamin Supplements Could Reduce Hospital Costs

July 25, 1997

Contact:
Moira Saucer
(202) 872-1488

VITAMIN SUPPLEMENTS COULD REDUCE HOSPITAL COSTS BY NEARLY $20 BILLION

Mounting scientific evidence suggests that significant reductions in birth defects, premature birth, and coronary heart disease can be achieved with daily vitamin intakes. Regular use of several specific vitamins to prevent these three conditions could also save $20 billion in U.S. annual hospital costs, according to a new study on the cost impact of preventive nutrition. Savings to Medicare alone would be $11 billion per year.

The analysis, published in the May issue of The Western Journal of Medicine, found that the projected savings (see chart, page 3) could be achieved by daily vitamin E supplementation by those over 50 and daily use of folic acid and zinc containing supplements by women of childbearing age.

Researchers used published risk reduction estimates associated with vitamin use to determine the potential reductions in annual hospitalizations for these costly ailments. They determined that hospital charges for heart disease, birth defects, and low birth weight premature births could be reduced about 38, 40, and 60 percent, respectively. Moreover, compared with other preventive interventions, vitamin supplementation can yield benefits "relatively quickly," said researchers.

The study was authored by Adrianne Bendich, Ph.D., of Roche Vitamins, Inc., and Rajiv Mallick, Ph.D. and Shelah Leader, Ph.D. of Pracon, a firm specializing in health economics. It was supported by Roche Vitamins, Inc.

Vitamin E and Reduced Rates of Coronary Heart Disease: Study authors estimated the proportion of cardiovascular disease that could be prevented with daily vitamin E intakes and concluded that supplementation could cut $4.7 to 5.6 billion in annual hospital charges for men and women over 50. They similarly analyzed the impact of vitamin E supplementation on the rates of non-fatal myocardial infarction and estimated savings ranging from $13 to nearly $14 billion in preventable hospital charges.

A number of studies have found that intakes of at least 100 international units (IU) per day of vitamin E, taken over a period of two or more years, can help reduce overall mortality from heart disease as well as non-fatal heart attacks. Normal dietary intakes, however, are only about 10 IU per day. Natural sources of vitamin E contain relatively small amounts of the nutrient and are prohibitively high in fat--making it impractical to recommend that people get optimal levels from their foods.

Folic Acid and Prevention of Birth Defects: Consistent findings in the scientific literature show that folic acid supplements are effective in protecting against neural tube birth defects. Folic acid supplementation of 400 mcg per day by all women of childbearing age could help prevent neural tube birth defects and save $73 to $89 million a year in preventable hospitalizations. Folic acid may also reduce the number of babies born with cardiovascular birth defects and could lower hospital charges from these birth defects by more than $1 billion per year.

Only about 25 percent of women of childbearing age consume protective levels of 400 mcg of folic acid per day as recommended by health authorities. More than 4600 babies with a primary diagnosis of neural tube defects were discharged from U.S. hospitals in 1992, representing $141 million in hospital charges.

Low Birth Weight and a Zinc Containing Multivitamin: Daily use of a multivitamin containing 15 to 20 milligrams of zinc could potentially reduce annual hospital charges associated with low birth weight by $173 million to $1.5 billion.

Low birth weight associated with pre-term delivery cost approximately $2.6 billion in 1995. Poor women, including pregnant teenagers, have a disproportionate number of preterm deliveries, costing Medicaid $1.3 billion. Intervention and observational studies have estimated that between 6.7 and 58.8 percent of all low birth discharges could be prevented with a multivitamin containing zinc.

Researchers observed that, "In all the cases examined, the micronutrients associated with improved outcomes (folic acid, zinc, vitamin E) are not present consistently in average diets at the levels associated with risk reduction. Importantly, the highest dietary intake and concomitant use of supplements is associated with the greatest risk reduction."

The study authors also said that their analysis could be used to evaluate the cost-savings of providing multivitamin supplements through public assistance programs. "Our estimates of potential savings would predict added benefits of expanding the Special Supplemental Food Program to Women, Infants, and Children (WIC) to include multivitamin supplementation for all women of childbearing potential, rather than only for women who are already pregnant. These estimates can be used to evaluate the relative cost effectiveness of expansion of the Federal Food Stamp Program to include multivitamin supplements."

For a copy of "Potential Health Economic Benefits of Vitamin Supplementation," appearing in the May issue of The Western Journal of Medicine, contact the Council for Responsible Nutrition at (202) 872-1488.

Editor's Note: The U.S. Department of Agriculture is undertaking a two-year study to determine the feasibility and cost implications of allowing food stamp recipients to purchase supplements with their coupons. The study was required under a comprehensive welfare reform measure signed into law in August 1996. The results will be reported back to the House and Senate Agriculture Committees by December 15, 1998.

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Vitamin Supplements Could Reduce Hospital Costs By Nearly $20 Billion

Medical Beneficial Preventable Medicare
Condition Vitamin Hospital Cost
 Charges Savings 
 ($ millions) 
Coronary Supplemental
Heart Vitamin E
Disease
(Age over 50) $4,655-5,569 $3,266-3,908 
Nonfatal Supplemental 
Acute Vitamin E
Myocardial
Infarction $13,001-13,971 $7,730-8,314 
Neural Multivitamin
Tube with Folic 
Birth Acid
Defects $73-89
Cardiovascular Multivitamin 
Birth with Folic 
Defects Acid $1,047-1,135
Low Birth Multivitamin
Weight with Zinc
(Pre-term 
Delivery) $173-1,519

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