Cost comparison of vitamin D from egg biofortification: the case of Slovenia study

INTRODUCTION: Various food fortification possibilities have been suggested to prevent vitamin D deficiency. The aim of this article is to compare cost of direct vitamin D fortification, hen egg biofortification and individual supplementation. METHODS: The cost comparison was done for the Slovenian population over >1 of age (n = 2,050,916). The demographic data was sourced from Statistical office of Slovenia. The economic evaluation was done using the cheapest prescription drug and cheapest food supplement. Unfortified hen egg has total vitamin D efficacy (combined efficacy of cholecalciferol and dietary 25(OH)D3) of 2.4 μg/1 egg. For the production of one vitamin D fortified egg with total vitamin D efficacy of 11.98 μg/egg, Browning and Cowieson used feed containing 36.2 μg cholecalciferol and 9.99 μg of 25(OH)D3. The milk and yoghurt can be fortified by direct addition during manufacture. For the economic analysis, the prices of vitamin D3 and feed grade 25(OH)D3 were provided by DSM Nutritional Products. RESULTS: The economic comparison of the annual cost of 10 μg vitamin D/d/person was EUR 6.17 for prescription drugs, EUR 6.37 for food supplements, EUR 0.09 for direct milk fortification and EUR 0.12 for egg biofortification with vitamin D. The annual cost of 10 μg vitamin D/d/person for Slovenia (n = 2,050,916) would be EUR 12.66 million for prescription drugs, EUR 13.06 million for food supplements, EUR 0.18 million for direct milk fortification and EUR 0.26 for egg biofortification with vitamin D. CONCLUSIONS: In Slovenia, vitamin D drug prescriptions amounted to EUR 6.03 million in 2020. Considering the low cost of fortification, even a slight decrease in drug dosage due to the effect of fortified food could bring substantial savings. Regulatory challenges in EU and projected intake of vitamin D using egg fortification alone and in combination with milk fortification was described in article Vičič et. al.. KEY MESSAGES: • Vitamin D fortification is a cost-effective way of increasing vitamin D intake in the population.