Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil

Rodrigues, Viviane Belini; Silva, Everton Nunes da; dos Santos, André Marques; Santos, Leonor Maria Pacheco

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Campo DC	Valor	Lengua/Idioma
dc.contributor.author	Rodrigues, Viviane Belini	pt_BR
dc.contributor.author	Silva, Everton Nunes da	pt_BR
dc.contributor.author	dos Santos, André Marques	pt_BR
dc.contributor.author	Santos, Leonor Maria Pacheco	pt_BR
dc.date.accessioned	2026-06-11T14:15:38Z	-
dc.date.available	2026-06-11T14:15:38Z	-
dc.date.issued	2023-2-22	pt_BR
dc.identifier.citation	RODRIGUES, Viviane Belini; SILVA, Everton Nunes da; DOS SANTOS, André Marques; SANTOS, Leonor Maria Pacheco. Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil. PLOS ONE, v. 18, n. 2, e0281077, 2023. DOI: https://doi.org/10.1371/journal.pone.0281077. Disponível em: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0281077. Acesso em: 11 jun. 2026.	pt_BR
dc.identifier.uri	https://doi.org/10.1371/journal.pone.0281077	pt_BR
dc.identifier.uri	http://repositorio.unb.br/handle/10482/54735	-
dc.publisher	Public Library of Science (PLoS)	pt_BR
dc.rights	Acesso Aberto	pt_BR
dc.title	Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil	pt_BR
dc.type	Artigo	pt_BR
dc.subject.keyword	Ácido fólico	pt_BR
dc.subject.keyword	Defeitos do Tubo Neural (DTNs)	pt_BR
dc.subject.keyword	Farinhas - fortificação	pt_BR
dc.rights.license	© 2023 Rodrigues et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.	-
dc.identifier.doi	https://doi.org/10.1371/journal.pone.0281077	pt_BR
dc.description.abstract1	Anencephaly, encephalocele, and spina bifida are congenital neural tube defects and are the main causes of neonatal morbidity and mortality and impose a heavy economic burden on health systems. This study to estimates the direct costs of neural tube defects from the perspective of the Brazilian Ministry of Health, and the prevented cases and cost savings during the period in which mandatory folic acid fortification was in effect in the country (2010–2019). It is a top-down cost-of-illness oriented study based on the prevalence of the disorders in Brazil. Data were collected from the Brazilian Ministry of Health’s outpatient and hospital information system databases. The direct cost was estimated from the total patient-years, allocated by age and type of disorder. Prevented cases and cost savings were determined by the difference in the prevalence of the disorders in the pre- and post-fortification periods based on the total number of births and the sum of outpatient and hospital costs during the period. The total cost of outpatient and hospital services for these disorders totaled R$ 92,530,810.63 (Int$ 40,565,896.81) in 10 years; spina bifida accounted for 84.92% of the total cost. Hospital costs were expressive of all three disorders in the first year of the patient’s life. Between 2010 and 2019, mandatory folic acid fortification prevented 3,499 live births with neural tube defects and resulted in R$ 20,381,586.40 (Int$ 8,935,373.25) in hospital and outpatient cost savings. Flour fortification has proved to be a valuable strategy in preventing pregnancies with neural tube defects. Since its implementation, there has been a 30% decrease in the prevalence of neural tube defects and a 22.81% decrease associated in hospital and outpatient costs.	pt_BR
dc.identifier.orcid	https://orcid.org/0000-0002-2389-820X	pt_BR
dc.contributor.affiliation	University of Brasılia, Graduate Program in Collective Health	-
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