how could food supplements contribute to healthcare cost ... bernd habe… · ca/vit. d omega-3...
TRANSCRIPT
How could food
supplements contribute to
healthcare cost savings?
Bernd Haber, BASF SE NPN Symposium „Gezondheidswinst metvitamines en mineralen“ , 22.11.2018
28.11.20182
Agenda
Are we living healthy?
Do we know our needs? – example: Vitamin D
Health Care Cost Savings – Can supplements play a role?
1.
2.
3.
28.11.20183
Agenda
Are we living healthy?
Do we know our needs? – example: Vitamin D
Health Care Cost Savings – Can supplements play a role?
1.
2.
3.
28.11.2018 | Optionale Zusatzinformationen4
Healthy nutrition for all – but what is reality?
Energy intake toohigh in many
countries
Increasingoverweight and
obesity
Micronutrient intakeoften below
recommendations
NCDs dominate theglobal pattern of
mortality
28.11.2018 | Optionale Zusatzinformationen5
More than 50% of Europeans are overweight or obese.
28.11.2018 | Optionale Zusatzinformationen6
Overweight and obesity is increasing tremendously not only in
Western countries.
28.11.2018 | Optionale Zusatzinformationen7
Micronutrient deficiency or insufficiency is not only a problem of
developing countries.
[Troesch et al, BJN, 2012]
367
3,966
5,006
9,146
0.5
2.9
2010
2.6
2005
2.0
2000
1.4
1995
0.4
1.0
Japan
China
Germany
USA
2013
BASF Human Nutrition8
Preventing NCDs before treatment makes sense as global health
costs explode
EXPENDITURE ON HEALTH
Total expenditure
in trillion USD
2013 per capita expenditure
in USD
Health promotion
and
disease prevention
have to be a central
part of any national
and international
health policy!
BASF Human Nutrition9
Is there more than improving our diet and lifestyle?
A healthy diet & lifestyle is
the cornerstone of disease
prevention.
Tailored nutrient supply can help
maintaining healthy life and
reducing disease risk.
28.11.201810
Agenda
Are we living healthy?
Do we know our needs? – example: Vitamin D
Health Care Cost Savings – Can supplements play a role?
1.
2.
3.
Vitamin D has multiple health benefits –
bone health is extensively studied
1 out of 3 women and 1
out of 5 men suffer from
osteoporotic fracture.
Every 3 seconds a bone
breaks due to
osteoporosis worldwide.
125 million people
suffer from osteoporosis
in Europe, India, Japan
and the USA.
28.11.201812
Recommendations
Vitamin D / day (dietary
recommendation)
German Nutrition
Society (DGE):
Recommended Intake(when endogenous synthesis is
missing)
20 µg
(800 IU)
IOF:
Recommended Intake
min. 20-25 µg
(800-1000 IU)
Intake from dietAdults in Germany (NVS II, 2008)
2,9 µg (men)
2,2 µg (women)
German Nutrition Society (DGE):
serum 25-hydroxyvitamin D concentrations of 50
nmol/l (20 ng/mL) or higher are considered an
indicator of an optimal vitamin D status.
International Osteoporosis Foundation (IOF):
“… there is emerging evidence and expert opinion
that the minimum blood level of 25(OH)D that
would be optimal for fracture prevention is 70-80
nmol/l (28-32 ng/mL)”
28.11.2018 | Optionale Zusatzinformationen13
Vitamin D – who knows his status?
28.11.201814
Prevalence of low vitamin D status is globally high.
DEFICIENT INSUFFICIENT (IN)ADEQUATE OPTIMAL25 [nmol/l]50 75 100
88.1% < 75 nmol/l
37.3% < 50 nmol/l
6.7% < 25 nmol/l
DGE IOF
[Hilger et al., BJN, 2014]
28.11.201815
Especially elderly people have a substantial risk of vitamin D
deficiency.
German Nutrition Society (2012)
„Among individuals 65 years and older, there is
greater need to take a vitamin D supplement
because the vitamin D synthesis capability of the skin
decreases significantly with increasing age...“
„The contribution of endogenous synthesis is further
reduced if people stay inside most of the time,
thereby reducing UVB exposure, which is often the
case especially among chronically sick elderly people
in need of care with restricted mobility...“
[German Nutrition Society, Ann Nutr Metab 2012;60:241–246]
[Conzades et al. Nutrients 2017, 9(12), 1276]
28.11.201816
How is the vitamin D status of BASF employees, especially after the
winter season?
Method
◼ More than 1000 employees (BASF
Ludwigshafen)
◼ Determination of 25(OH)D-serum levels on
voluntary basis
◼ Assessment after winter (15.3.-31.4.2017) and
summer season (15.-31.10.2017)
◼ Questionnaire about lifestyle factors especially
sun exposure and intake of vitamin D
supplements
Target
◼ Determination of 25(OH)D-serum
levels of at least 1000 employees at
the end of the winter season
(winter value)
◼ Control of the endogenous synthesis
of vitamin D in the summer months
(summer value)
25(OH)D concentration in serum (winter levels)
28.11.201817
Approx. 70% of BASF employees have deficient or insufficient vitamin D
status after the winter season.
31%
38%
21%
9%
1%
<12ng/ml(Deficiencyl)
12-20ng/ml(Insufficiency)
>20-30ng/ml(Lower normal)
>30-60ng/ml(Upper normal)
>60ng/ml (Abovenormal)
34
40
20
5
1
5
15
32
42
7
0%
10%
20%
30%
40%
50%
<12 12-20 >20-30 >30-60 >60
No supplements
Supplements use
25(OH)-D-concentration in serum (ng/ml)
% o
fin
div
idu
als
Vitamin D3 supplementation significantly improved
the vitamin D3 status after winter season.
28.11.201818
Still approx. 20% of BASF employees have deficient or insufficient
vitamin D status after the summer season.
2%
17%
40%
40%
2%
<12ng/ml(Deficiency)
12-20ng/ml(Insufficiency)
>20-30ng/ml(Lower normal)
>30-60ng/ml(Upper normal)
>60ng/ml (Abovenormal)
25(OH)D concentration in serum (summer levels)
25(OH)-D-concentration in serum (ng/ml)
2
19
43
35
104
22
67
7
0
10
20
30
40
50
60
70
80
No supplements
Supplements use
< 12 12-20 >20-30 >30-60 >60
% o
fin
div
idu
als
Vitamin D3 supplementation further optimized the
vitamin D3 status after the sommer season.
BASF Human Nutrition19
People are different. People have different needs.
Diagnosis is essential for personalized recommendations.
Weizman personalized nutrition
project (2015)Challenges of the future
Diagnose
Monitor
Comply
Solution for the future
Easy diagnosis
leads to consumer
awareness
Positive effect
triggers additional
motivation
Regular
measurement
shows impact of DS
28.11.201820
Agenda
Are we living healthy?
Do we know our needs? – example: Vitamin D
Health Care Cost Savings –
Can supplements play a role?
1.
2.
3.
28.11.201821
The world’s major regions are
expected to see health care spending
increase from 2.4 to 7.5 percent
between 2015 and 2020.
Source: Deloitte
ALTHOUGH PEOPLE ARE LIVING
LONGER, THEY ARE NOT
NECESSARILY HEALTHIER THAN
BEFORE - NEARLY A QUARTER
(23%) OF THE OVERALL GLOBAL
BURDEN OF DEATH AND ILLNESS
IS IN PEOPLE AGED OVER 60
Source: WHO
TOTAL NUMBER OF DISABILITY-ADJUSTED LIFE YEARS
LOST (DALYS) PER COUNTRY DUE TO OSTEOPOROSIS-
ATTRIBUTED BONE FRACTURES, GLOBAL 2015
SOURCE: FROST & SULLIVAN
853.093
348.665
313.813
129.688
110.363
88.215
71.327
35.615
19.939
16.278
14.991
14.841
7.583
5.464
1.606
EU
RUSSIA
CHINA
TURKEY
US
INDIA
JAPAN
BRAZIL
REP KOREA
INDONESIA
ARGENTINA
CANADA
AUSTRALIA
SOUTHAFRICA
NEWZEALAND
Total number of DALYS due to osteoporosis-attributed bone
fractures are exceptionally high in the EU.
The cost of osteoporosis-attributed fractures, in terms of lost
healthy life years lost, is over 2 million years per year globally.
24
What kind of policy action needs to be taken?
Can supplements play a role?
Food Supplements Europe commissioned
Frost & Sullivan to investigate if daily
supplementation of the diet with specific
food compounds would be able to reduce
disease risk in adults over 55+ and result
in healthcare costs savings.
Ca/Vit. D
Omega-3
Phytosterols
The effect of Calcium and
Vitamin D supplementation
Cost of treating bone fractures with wider use of
Calcium + vitamin D supplements
27.8 million
17.6 % of people aged 55 +
in the EU living with osteoporosis
Cost of treating bone fractures with wider use of
Calcium + vitamin D supplements
cost of treating these fractures
€26.4bn / year€21,231 / event
1.24m related fractures
occurring
every year
-15%Reduction of risk of
osteoporosis-attributed fractures by regular consumption of
1000 mg Calcium + 15 mcg Vitamin D
Cost of treating bone fractures with wider use of
Calcium + vitamin D supplements
Cost of treating bone fractures with wider use of
Calcium + vitamin D supplements
Permitted claim:
“Calcium and vitamin D help to
reduce the loss of bone mineral in
post-menopausal women. Low
bone mineral density is a risk factor
for osteoporotic bone fractures.”
The claim may be used only for food supplements which
provide at least 400 mg of calcium and 15 μg of
vitamin D per daily portion. Information shall be given to the
consumer that the claim is specifically intended for women 50
years and older and the beneficial effect is obtained with a
daily intake of at least 1 200 mg of calcium and 20 μg
of vitamin D from all sources. For food supplements with
added calcium and vitamin D the claim may be used only for
those targeting women 50 years and older
The EU has permitted a health claim for calcium and
vitamin D and risk of osteoporosis.
€3.47 return for every
€ 1spent on
calcium + vitamin D
supplements
186,690 osteoporosis-attributed bone fractures
preventable every year
Total savings generated inthe EU over 5 years through regular use ofCalcium + Vitamin D supplements(equivalent to € 3.96 bn per annum)
19.8 billion
Cost of treating bone fractures with wider use of
Calcium + vitamin D supplements
The effect of Omega 3
supplementation
Number and percentage of over 55s in the EU considered to be at risk of experiencing a CVD-attributed hospital event
24%
€ 34,637 / event
€ 1.33 trillion
5 years
38.4m
31%Aged 55+
How Omega 3 could save
€13 bn a year
in EU healthcare costs
Reduction in the relative risk of an individual aged 55+ experiencing a CVD-attributed hospital event through the daily consumption of:
1000 mg Omega 3 EPA+DHA
-4.9%
How Omega 3 could save
€13 bn a year
in EU healthcare costs
How Omega 3 could save
€13 bn a year
in EU healthcare costs
The EU has permitted several health claims for
omega-3 in the context of heart health.
EPA and DHA contribute to
the normal function of the
heart
DHA and EPA contribute to
the maintenance of normal
blood triglyceride levels
DHA and EPA contribute to
the maintenance of normal
blood pressure
For foods which are at least a
source for omega-3
Min. 250 mg/day
For food which provides a
daily intake of 3 g of EPA and
DHA
For food which provides a
daily intake of 2 g of EPA and
DHA
€ 64.5billionTotal savings generated in the EU over 5 years through more widespread regular use of Omega 3 supplements (equivalent to € 12.9 bn per year)
Number of preventable cases, over 5 years, of CVD in people aged 55+ through more widespread regular use of Omega 3 food supplements
1.5million
€ 2.29return for every
€ 1spent on Omega-3
supplements
How Omega 3 could save
€13 bn a year
in EU healthcare costs
36
Supplementation of the diet with nutrients and food compounds can
lead to significant reductions of hospital events and thus healthcare
costs.
Ca/Vit. D
Omega-3
Phytosterols
Relative risk
reduction
Number of
preventable
events
(over 5 years)
Healthcare
costs savings
(over 5 years)
Return for every
€ 1 spent
- 4.9 % 1.5 Mn € 64.5 Bn € 2.29
- 2.3 % 0.85 Mn € 26.5 Bn € 4.37
- 15 % 0.93 Mn € 19.8 Bn € 3.47
More information under: www.foodsupplementseurope.org
28.11.201837
Conclusion
◼ A rethink of our understanding of health is needed. Health promotion should be in the center of policy
activities.
◼ Food supplements can play an important role to close nutritional gaps and meet individual needs.
◼ Diagnosis of the individual nutritional needs and regular measurement about the effect of
supplementation are important steps to improve the nutritional status of people and improve their
overall health.
◼ Health care costs are steadily increasing. Food supplements can help to reduce health care costs
and thus should be considered as one measure in policy making.
28.11.201838
Special Thanks
Patrick Coppens
Ute Obermüller-Jevic
Marianne Heer
Mareike Kampmann