Cost of fluoridated milk

Milk programmes which are targeted at schools and/or socially deprived communities, often attract subsidies and in many cases the milk is supplied free of charge. The funding is usually provided from local authority/municipality budgets, although in some cases support is provided directly from central government. Such an example occurs in Chile where the Programa de Alimentación Escolar (PAE), operated by the government funded agency Junta Nacional de Auxilio Escolar y Becas (JUNAEB), provides the milk which is used as a vehicle for the delivery of fluoride.

The actual process of adding fluoride to milk is relatively straightforward and as the cost differential between production of fluoridated and non-fluoridated milk is marginal, it is generally absorbed by the milk producers. However, there are exceptions for example in the Bulgarian schemes; fluoridated yoghurt is approximately 20% higher than non-fluoridated yoghurt, whereas fluoridated milk can be up to 25% lower than milk products sold competitively on the open market. This is attributable to its basic packaging as opposed to the cartons which although more attractive, are significantly more expensive.

The additional cost of providing fluoridated milk compared with non-fluoridated milk was reported in a publication by Mariño et al. (2007) which presented a cost-effective analysis of a fluoridated milk programme in Chile. The cost of the programme per child per year was 1,839.75 Chilean pesos; equivalent, in 1999, to US$ 3.49 per child per year. Eighty per cent of this cost (US$ 2.79) was accounted for by the programme co-ordinator, office facilities, and the additional cost of adding fluoride to the milk feed. The remaining 20% was the cost of monitoring fluoride concentrations in the fluoridated milk and in the children's urine, and for additional dental examinations requested by the health authorities.

In the UK, the cost to the health authorities of providing fluoridated milk compared with non-fluoridated milk in England was estimated, in 2008, to be UK£ 1.25 per child per year. This sum included programme administration, travel to schools and supporting information for parents and healthcare professionals. This figure of UK£ 1.25 is equivalent (in 2008) to Euro 1.56 and US$ 2.43. Thus, information from Chile and England gives the additional cost of providing fluoridated milk, compared with non-fluoridated milk, at about two to three US dollars per child per year.