This HTA report examines the safety, the effectiveness, the costs and the cost-effectiveness of conducting folate tests on symptom-free persons and on persons for whom symptoms, medical problems or other factors suggest a possible folate deficiency. The report further examines ethical, social and organisational issues in connection with folate testing.
A systematic survey of the relevant available literature (including clinical studies) revealed no direct proof of any impact of folate tests on the recipient’s health. No indirect proof could be found, either. The diagnostic accuracy of such tests has only been examined by a single study, whose results were biased and are essentially inapplicable to Switzerland. Whether folate tests significantly influence subsequent treatment decisions remains similarly unproven. The report’s assessment of the future cost impact of such folate tests in the 2022-2026 period suggests that the costs thereof will rise from CHF 14.3 million for 2022 to CHF 21.5 million for 2026.
The report concludes that the safety and the effectiveness of folate testing are uncertain. According to the studies examined, the provision of supplementary folic acid is considered safe, even if this is undertaken without a prior folate test. Such provision is linked to reducing the risk of several chronic illnesses and health-damaging conditions.