Lewin Group Findings Show Cost Savings, Health Benefits for Five Selected Dietary Supplements: Calcium, Folic Acid, Omega-3 Fatty Acids, Glucosamine and Saw Palmetto

Washington, DC – September 22, 2004 – 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 Allen 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:

• Paul 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 Jean 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 Jeffrey 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 www.supplementinfo.org.

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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.

For more information, or to speak with the spokespersons outlined above, please contact:

Craig Brownstein - (202) 326-1799 / craig.brownstein@edelman.com  
Beth Mallard – (202) 312-1084 / beth.mallard@edelman.com
Deb Knowles - (941) 349-9044 / debknowles@supplementinfo.org

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Source: DaVanzo, J. et al, "Improving Public Health, Reducing Health Care Costs: An Evidence-Based Study of Five Dietary Supplements," September 22, 2004.

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

• 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 releasedreview 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.)