Cost Effectiveness of Micronutrient Supplementation in India: A Scoping Review

Background: Micronutrient deficiencies decrease cognitive capacity, economic productivity, and quality of life. Micronutrient deficiencies, also called hidden hunger, may contribute to 2-12% of the total DALYs in high-burden countries. However, despite the growing burden, the evidence on the cost-effectiveness of the interventions to prevent or control micronutrient deficiencies is limited and varies. Hence, we conducted a scoping review of the published literature to assess the cost-effectiveness of the micronutrient interventions in India. Methods: We searched four electronic databases, including PubMed/MEDLINE, Web of Science, EBSCO, and Applied Social Sciences Index and Abstracts. We used the search strategy using the keywords ("micronutrient” OR “micronutrient supplementation”) AND ("cost-effectiveness" OR "cost utility" OR "economic evaluation" OR "cost benefit") AND India. Our searches were limited to literature published until 07 August 2025. The initial search for this scoping review yielded 72 records. Results: Our review comprised 14 studies in total, which were conducted mostly in India and other high-burden Asian and African nations, and concentrated on the impact and cost-effectiveness of several micronutrient therapies. Evidence on micronutrient supplementation and food fortification in India was synthesized in this scoping review from 14 diverse studies, including economic modeling, social cost-benefit analysis, <i>ex ante</i> assessments, systematic reviews, and RCT, confirming that these are highly cost-effective strategies for combating hidden hunger and its related disease burden. Similarly, biofortification of staple crops like rice and wheat at large-scale with essential nutrients such as iron and zinc, fortification of regularly consumed products such as double-fortified salts and wheat flour, deliver significant health benefits at a relatively low cost per DALY averted. Conclusions: To meet national nutrition targets and eventually improve the health and well-being of India’s people, it is imperative and economically reasonable to prioritize the scale-up of MMS and large-scale or universal food fortification projects.