Unit of Epidemiology, Scientific Institute of Public Health, Brussels, Belgium.
Thyroid. 2010 Nov;20(11):1301-6. doi: 10.1089/thy.2010.0133.
Several surveys in the last 50 years have repeatedly indicated that Belgium is affected by mild iodine deficiency. Within the framework of the national food and health plan in Belgium, a selective, progressive, and monitored strategy was proposed in 2009 to optimize iodine intake. The objective of the present study was to perform a health economic evaluation of the consequences of inadequate iodine intake in Belgium, focusing on undisputed and measurable health outcomes such as thyroid nodular disease and its associated morbidity (hyperthyroidism).
For the estimation of direct, indirect, medical, and nonmedical costs related to thyroid nodular diseases in Belgium, data from the Federal Public Service of Public Health, Food Chain Safety and Environment, the National Institute for Disease and Disability Insurance (RIZIV/INAMI), the Information Network about the prescription of reimbursable medicines (FARMANET), Intercontinental Marketing Services, and expert opinions were used. These costs translate into savings after implementation of the iodization program and are defined as costs due to thyroid nodular disease throughout the article. Costs related to the iodization program are referred to as program costs. Only figures dating from before the start of the intervention were exploited. Only adult and elderly people (≥18 years) were taken into account in this study because thyroid nodular diseases predominantly affect this age group.
The yearly costs due to thyroid nodular diseases caused by mild iodine deficiency in the Belgian adult population are ∼€38 million. It is expected that the iodization program will result in additional costs of ∼€54,000 per year and decrease the prevalence of thyroid nodular diseases by 38% after a 4-5-year period. The net savings after establishment of the program are therefore estimated to be at least €14 million a year.
Optimization of iodine intake in Belgium should be quite cost effective, if only considering its impact on nodular thyroid disease. There are likely added benefits relating to more optimal thyroid hormone influenced brain development that are more difficult to estimate but may be even more important.
在过去的 50 年里，有几项调查反复表明比利时受到轻度碘缺乏症的影响。在比利时国家食品和健康计划的框架内，2009 年提出了一项选择性、渐进性和监测性战略，以优化碘的摄入量。本研究的目的是对比利时碘摄入不足的后果进行健康经济评估，重点关注甲状腺结节疾病及其相关发病率（甲状腺功能亢进症）等无可争议和可衡量的健康结果。
为了估算与比利时甲状腺结节疾病相关的直接、间接、医疗和非医疗成本，本研究使用了联邦公共卫生局、食品链安全和环境局、国家疾病和残疾保险研究所（RIZIV/INAMI）、可报销药品处方信息网络（FARMANET）、洲际营销服务公司和专家意见的数据。这些成本在实施碘化物计划后转化为节省，在整篇文章中被定义为整个甲状腺结节疾病相关的成本。与碘化物计划相关的成本被称为计划成本。本研究仅利用了干预措施开始前的数据。由于甲状腺结节疾病主要影响这一年龄组，因此仅考虑了成年人和老年人（≥18 岁）。
比利时成年人群因轻度碘缺乏导致的甲状腺结节疾病每年造成的成本约为 3800 万欧元。预计碘化物计划每年将增加约 54000 欧元的成本，并在 4-5 年后将甲状腺结节疾病的患病率降低 38%。因此，该计划建立后的净节省额预计至少为每年 1400 万欧元。
如果仅考虑其对结节性甲状腺疾病的影响，优化比利时的碘摄入量应该是相当具有成本效益的。可能还有与更理想的甲状腺激素影响大脑发育相关的额外收益，这些收益更难估计，但可能更重要。
