Cost savings of reduced constipation rates attributed to increased dietary fiber intakes: a decision-analytic model

BMC Public Health

Dominik D Alexander³  Lisa M Sanders⁴  Latha Devareddy⁴  Tia M Rains⁵  Kevin C Maki⁵  Vanessa Perez¹  Jessica A Levine²  Paige E Miller¹  Jordana K Schmier² 

[1] Exponent Inc., 525 W. Monroe Street Suite 1050, Chicago, IL 60661, USA;Exponent Inc., 1800 Diagonal Road Suite 500, Alexandria, VA 22314, USA;Exponent Inc., 4141 Arapahoe Avenue Suite 101, Boulder, CO 80303, USA;The Kellogg Company, 2 Hamblin Ave, Battle Creek, MI 49015, USA;Biofortis–Provident Clinical Research, 211 E. Lake Street #117, Addison, IL 60101, USA

关键词: Lifestyle;    Diet;    Fiber;    Cost-savings;    Prevention;    Public health;    Constipation;   

Others  :  1131540
DOI  :  10.1186/1471-2458-14-374

 received in 2013-10-02, accepted in 2014-04-12,  发布年份 2014

【 摘 要 】

Background

Nearly five percent of Americans suffer from functional constipation, many of whom may benefit from increasing dietary fiber consumption. The annual constipation-related healthcare cost savings associated with increasing intakes may be considerable but have not been examined previously. The objective of the present study was to estimate the economic impact of increased dietary fiber consumption on direct medical costs associated with constipation.

Methods

Literature searches were conducted to identify nationally representative input parameters for the U.S. population, which included prevalence of functional constipation; current dietary fiber intakes; proportion of the population meeting recommended intakes; and the percentage that would be expected to respond, in terms of alleviation of constipation, to a change in dietary fiber consumption. A dose–response analysis of published data was conducted to estimate the percent reduction in constipation prevalence per 1 g/day increase in dietary fiber intake. Annual direct medical costs for constipation were derived from the literature and updated to U.S. $ 2012. Sensitivity analyses explored the impact on adult vs. pediatric populations and the robustness of the model to each input parameter.

Results

The base case direct medical cost-savings was $12.7 billion annually among adults. The base case assumed that 3% of men and 6% of women currently met recommended dietary fiber intakes; each 1 g/day increase in dietary fiber intake would lead to a reduction of 1.9% in constipation prevalence; and all adults would increase their dietary fiber intake to recommended levels (mean increase of 9 g/day). Sensitivity analyses, which explored numerous alternatives, found that even if only 50% of the adult population increased dietary fiber intake by 3 g/day, annual medical costs savings exceeded $2 billion. All plausible scenarios resulted in cost savings of at least $1 billion.

Conclusions

Increasing dietary fiber consumption is associated with considerable cost savings, potentially exceeding $12 billion, which is a conservative estimate given the exclusion of lost productivity costs in the model. The finding that $12.7 billion in direct medical costs of constipation could be averted through simple, realistic changes in dietary practices is promising and highlights the need for strategies to increase dietary fiber intakes.

【 授权许可】

   
2014 Schmier et al.; licensee BioMed Central Ltd.

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