Introduction: Folic acid is the most thoroughly studied preventive measure during the periconceptional period for the prevention of neural tube defects. Because the neural tube closes within the first 28 days after conception, often before a woman is aware that she is pregnant, timely supplementation is essential for effective prevention. In Slovenia, women planning a pregnancy are advised to take a daily dose of 400 μg of folic acid for at least three months prior to conception and during the first three months of pregnancy. Purpose: The purpose of this thesis is to evaluate the economic justification of individual folic acid supplementation in women planning a pregnancy as a preventive strategy for reducing the incidence of neural tube defects in Slovenia. Methods: The thesis is based on a review of professional literature. The economic justification of folic acid supplementation was evaluated using cost-effectiveness analysis and cost-benefit analysis. Results: The results of the analysis show that the cost of preventing a single neural tube defect case in all examined scenarios is lower than the lifetime cost of treating spina bifida. With optimal and timely intake of folic acid, a large proportion of the annually expected neural tube defects cases in Slovenia could theoretically be prevented. Discussion and conclusion: Individual folic acid supplementation during the periconceptional period proves to be a cost-justified preventive strategy that remains valid even under conservative assumptions; the actual benefit of the intervention is most likely higher than estimated. Since this approach is least likely to reach precisely those groups with lower compliance, the question of food fortification should also be considered. The establishment of a national registry of congenital anomalies, together with targeted awareness-raising among vulnerable groups, would contribute to more effective prevention in Slovenia.
|
