Supplementation with lutein and zeaxanthin could save €6.2 billion in avoidable medical costs in Europe

A new report from Frost & Sullivan suggests that daily supplementation with 10 mg lutein and 2 mg R,R’-zeaxanthin could save up to €6.2 billion in total medical costs resulting from age-related macular degeneration (AMD) in Europe (1).  To calculate healthcare cost savings, the analysis considered the prevalence of late-stage AMD in Europe (2), and the improvements in visual acuity for subjects using lutein and R,R’-zeaxanthin supplements versus placebo in a systematic review of clinical trials (3).  They concluded that the observed 7 percent improvement in visual acuity would translate into fewer severe/late stage AMD case transitions and significant cost savings, including €6.2 billion in total saved costs per year, and a return of €5.01 for every €1.00 invested in lutein and R,R’-zeaxanthin supplementation. 

The efficacy assumption on which the report was based is consistent with the 10 percent reduction in progression to late stage AMD that was observed in the Age-Related Eye Disease 2 (AREDS2) study conducted by the US National Institutes of Health (4).  The reported healthcare cost savings are also consistent with a 2013 Frost & Sullivan analysis on data from the United States (5). That study reported a $7.42 billion USD cumulative projected cost savings from 2013-2020 resulting from lutein and R,R’-zeaxanthin supplementation.

Lutein and R,R’-zeaxanthin, two carotenoids found in green vegetables, are known for their antioxidant activity and are found in the retina of the eye (6).  They are concentrated in the macula, which is colloquially known as the “yellow spot” (7).  In fact, the term “lutein” is derived from the Latin word for “yellow.”  Because intake of green vegetables is low in many developed countries, daily intake of total lutein and zeaxanthin is typically about 1-2 mg/day, far short of the beneficial amount in the above-referenced study (8,9). 

Healthcare costs aside, a price can’t be put on saving the eyesight of an individual.  Increasing consumption of green vegetables, or consuming dietary supplements containing “free” (unesterified) lutein and R,R’-zeaxanthin can help achieve the recommended levels of intake, a proactive step toward increasing macular pigment levels and supporting optimal eye health.

REFERENCES

1. Frost & Sullivan. The Economic Benefits of Using Lutein and Zeaxanthin Food Supplements in the European Union [Internet]. Frost & Sullivan. 2017 [cited 2017 Oct 18]. Available from: https://ww2.frost.com/frost-perspectives/economic-benefits-using-lutein-and-zeaxanthin-food-supplements-european-union/
2. Colijn JM, Buitendijk GHS, Prokofyeva E, Alves D, Cachulo ML, Khawaja AP, Cougnard-Gregoire A, Merle BMJ, Korb C, Erke MG, et al. Prevalence of Age-Related Macular Degeneration in Europe: The Past and the Future. Ophthalmology. 2017;
3. Liu R, Wang T, Zhang B, Qin L, Wu C, Li Q, Ma L. Lutein and zeaxanthin supplementation and association with visual function in age-related macular degeneration. Invest Ophthalmol Vis Sci. 2015;56:252–8.
4. The Age-Related Eye Disease Study 2 (AREDS2) Research Group, Chew EY, SanGiovanni J, et al. Lutein/zeaxanthin for the treatment of age-related cataract: Areds2 randomized trial report no. 4. JAMA Ophthalmol. 2013;131:843–50.
5. Frost & Sullivan. Smart Prevention - Health Care Cost Savings Resulting from the Targeted Use of Dietary Supplements. Frost & Sullivan, 2013 [Internet]. 2013. Available from: http://www.frost.com/sublib/display-market-insight.do?id=285115104
6. Johnson EJ. Role of lutein and zeaxanthin in visual and cognitive function throughout the lifespan. Nutr Rev. 2014;72:605–12.
7. Bone RA, Landrum JT, Tarsis SL. Preliminary identification of the human macular pigment. Vision Res. 1985;25:1531–5.
8. Cena H, Roggi C, Turconi G. Development and validation of a brief food frequency questionnaire for dietary lutein and zeaxanthin intake assessment in Italian women. Eur J Nutr. 2008;47:1–9.
9. Johnson EJ, Maras JE, Rasmussen HM, Tucker KL. Intake of Lutein and Zeaxanthin Differ with Age, Sex, and Ethnicity. J Am Diet Assoc. 2010;110:1357–62.