What Is The Cost Versus The Benefit Of Fortification?

The cost and benefit of fortification intervention is well studied and documented. Among the most common vitamins and minerals fortified, the payback ranges from over 120:1 to 6:1. And since many of the expenses associated with fortification are shared among different programs, the overall payback for a comprehensive fortification program is enormous.

Nutrient	Annual cost per person	Benefits
Folic Acid	4 to 5 cents	Shown to reduce neural tubal defects (the second most common class of birth defects) by over 70% resulting in a 24:1 first year payback. Also believed to significantly reduce the incidence of cleft lip and cleft palates which cost approximately $4,900 per incident to repair and the savings from surgery alone represent a 3.5:1 payback for the country – collectively these two represent a combined payback of 120:1. A recent study concluded that increasing U.S. levels of fortification would save 50,000 U.S. lives and millions in heath care expense, which suggests an enormous but difficult to calculate worldwide savings.

Iodine	1-2 cents	Iodine deficiency affects thyroid function and the regulation of gene expression. Adequate iodine fortification increases IQ among children by 10 to 15%, reduces the incidence of goiters by over 70%, and all but eliminates cretinism which affects 100,000 children worldwide.

Iron	Less than 10 cents	Iron deficiency affects 3.5 billion in the developing world – 2 out of every 3 people. Annual productivity losses per capita from iron deficiency is estimated at $0.32 per year while the cost to fortify the population is such that the annual economic payback ranges from 6:1 to 36:1.

Vitamin A	4 cents	Vitamin A deficiency affects vision, gene expression, and the immune system leading to the death of one million children each year and 500,000 children go blind each year from inadequate levels of vitamin A. It is estimated that vitamin A fortification efforts reduce these incidence by over 20%.