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20X increase in vitamin D sold and 36 percent decrease in osteoporosis business in Australia – Nov 2013

Archives of Osteoporosis, November 2013, 8:161
David Rowell, Louisa Gordon

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Increased use of D category listing has 34 items along with related searches

Increased Use of Vitamin D category in VitaminDWiki

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6468 Many more people now have vitamin D levels above 50 ng, especially seniors – May 2015 10348
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5432 Vitamin D testing AND levels are increasing in Australia (NSW) – May 2014 4081
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6604 Vitamin D supplementation in Ireland - big increase in people with 20-50 nanograms in 20 years – June 2015 3697
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7879 Increased use of D 3363
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7910 Huge increase in Vitamin D supplementation in the US military (2005-13) – Oct 2016 2405
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7875 Vitamin D use increased 3.7 X, Omega-3 increased 9 X (US 1999-2012) – JAMA Oct 2016 1838
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8335 NHL discovers Vitamin D – their ideal is 40-120 ng – 2016 1762
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8305 Recent increase in Vitamin D levels in Elite Irish Athletes – Aug 2016 1598
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6632 Vitamin D levels increasing 7 percent per year, bones denser in Japan (probably supplementation) - June 2015 1438
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7567 4 times fewer with vitamin D deficiency in just 4 years ( Connecticut) – March 2016 1397
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8001 Vitamin D levels increasing in US elderly, whites, and women – CDC Nov 2016 1392
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8088 Vitamin D levels in US: percent having more than 40 ng doubled (2001-2010) - Dec 2016 1349
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8118 Vitamin D in US children: those having more than 40 ng increased 60 percent (2001-2010) - Dec 2016 1299
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7886 Vitamin D fortification is returning to Finland – now 400 IU per 100 gram of butter – Oct 2016 1265
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10074 Army Training trying performance readiness bars with 1400 IU of Vitamin D (Dr. Matthews) – Sept 2018 1110
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8437 Vitamin D levels in Finland increased 2000-2011 (supplementation and fortification) – May 2017 1106
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Increased use of D

Overview Osteoporosis and vitamin D contains the following summary

  • FACT: Bones need Calcium (this has been known for a very long time)
  • FACT: Vitamin D improves Calcium bioavailability (3X ?)
  • FACT: Should not take > 750 mg of Calcium if taking lots of vitamin D (Calcium becomes too bio-available)
  • FACT: Adding vitamin D via Sun, UV, or supplements increased vitamin D in the blood
  • FACT: Vitamin D supplements are very low cost
  • FACT: Many trials, studies. reviews, and meta-analysis agree: adding vitamin D reduces osteoporosis
  • FACT: Toxic level of vitamin D is about 4X higher than the amount needed to reduce osteoporosis
  • FACT: Co-factors help build bones.
  • It appears that to TREAT Osteoporosis:
  •        Calcium OR vitamin D is ok
  •        Calcium + vitamin D is good
  •        Calcium + vitamin D + other co-factors is great
  • CONCLUSION: To PREVENT many diseases, including Osteoporosis, as well as TREAT Osteoporosis
  • Category Osteoporosis has 182 items
  • Category Bone Health has 254 items

Note: Osteoporosis causes bones to become fragile and prone to fracture
  Osteoarthritis is a disease where damage occurs to the joints at the end of the bones

Summary: This descriptive paper identifies some salient trends in the Australian management of osteoporosis. Changes in pharmaceutical consumption and medical utilisation are analysed. The total national consumption of four pharmaceuticals is estimated. From 2001 to 2011, the consumption of bisphosphonates and vitamin D increased. After 2006, the management rate for osteoporosis decreased.

Purpose: During the first decade of the millennia, the total cost of vitamin D tests has increased significantly within many health care jurisdictions worldwide. Australia reports a 100-fold increase. Legitimately, concerns regarding the economic effectiveness of this test exist. The purpose of this paper is to identify what other salient clinical trends could affect the efficacy of this test when treating osteoporosis.

Methods: Longitudinal data from two Australian datasets are analysed. The first are data obtained from Medicare Australia, which report pharmaceutical consumption. The second are data obtained from a national survey of general practitioners.

Results: The management of osteoporosis has been characterised by a movement away from single to combination formularies. The consumption of calcium carbonate has declined, and the use of bisphosphonates has increased.
While the gross consumption of risedronate increased steadily over the decade (8.4 to 186.5 kg), the consumption of alendronate declined after 2007.
The consumption of vitamin D (over-the-counter and prescription) has increased from 0.58 to 2.8 kg over the decade. While prescription vitamin D comprised just 10 % of the total, its consumption has undergone a 20-fold increase since 2006. Importantly, we can also report that the management of osteoporosis by Australia's general practitioners increased steadily until 2007–2008, before declining by 36 %.

Conclusions: Further research is required to determine possible casual relationships that may exist between these data. Until a formal economic evaluation of vitamin D testing in this clinical setting is completed, no conclusions regarding its economic effectiveness should be drawn.

References

  • Nowson CA, McGrath JJ, Ebeling PR, Haikerwal A, Daly RM, Sanders KM et al (2012) Vitamin D and health in adults in Australia and New Zealand: a position statement. Med J Aust 196(11):686–687 CrossRef
  • Lips P, Bouillon R, Van Schoor NM, Vanderschueren D, Verschueren S, Kuchuk N et al (2010) Review article: reducing fracture risk with calcium and vitamin D. Clin Endocrinol 73(3):277–285 CrossRef
  • Porter R, Kaplan J (2011) The Merck manual online. http://www.merck.com/mmpe/index.html. Accessed June 2013
  • Sattar N, Welsh P, Panarelli M, Forouhi NG (2012) Increasing requests for vitamin D measurement: costly, confusing, and without credibility. Lancet 379(9811):95–96 CrossRef
  • Bilinski KL, Boyages SC (2012) The rising cost of vitamin D testing in Australia: time to establish guidelines for testing. Med J Aust 197(2):90 CrossRef
  • Bilinski K, Boyages S (2012) The rise and rise of vitamin D testing. BMJ 345
  • Britt H, Miller GC, Charles J, Henderson J, Bayram C, Valenti L et al (2008) General practice activity in Australia 2006-07 (general practice series no. 21). Sydney University Press, Sydney. http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442456174. Accessed Nov 2012
  • Britt H, Miller GC, Charles J, Henderson J, Bayram C, Valenti L et al (2008) General practice activity in Australia 1999-99 to 2007-08: 10 year data tables (general practice series no. 23). Sydney University Press, Sydney. http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442456227. Accessed Nov 2012
  • Britt H, Miller GC, Charles J, Henderson J, Bayram C, Valenti L et al (2009) General practice activity in Australia 1999-00 to 2008-09: 10 year data tables (general practice series no. 26). Sydney University Press, Sydney. http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442456294. Accessed Nov 2012
  • Britt H, Miller GC, Charles J, Henderson J, Bayram C, Valenti L et al (2010) General practice activity in Australia 2000-01 to 2009-10: 10 year data tables (general practice series no. 28). Sydney University Press, Sydney. http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442472732&libID=6442472713. Accessed Nov 2012
  • Britt H, Miller GC, Charles J, Henderson J, Bayram C, Valenti L et al (2011) A decade of Australian general practice activity 2001-02 To 2010-11 (general practice series no. 30). Sydney University Press, Sydney. http://ses.library.usyd.edu.au/bitstream/2123/7773/4/9781920899875_CDROM.pdf. Accessed Nov 2012
  • Britt H, Miller GC, Charles J, Henderson J, Valenti L, Harrison C et al (2012) A decade of Australian general practice activity 2002–03 to 2011–12. Accessed Aug 2013
  • Euromonitor International (2012) Vitamins and dietary supplements in Australia. Passport Euromonitor International, London
  • Wooldridge JM (2000) Introductory econometrics: a modern approach. Southern-Western College Publishing, Boston
  • Watts NB (2003) Bisphosphonate treatment of osteoporosis. Osteoporosis. Springer, Heidelberg, pp 459–473
  • Australian Bureau of Statistics (ABS) (2012) 4364.0.55.001 Australian health survey: first Results, 2011-12. ABS, Canberra
  • Medicare Australia (2012) Medicare Australia statistics: amalgamated PBS item reports on benefits for alendronate Na (8511Y). https://www.medicareaustralia.gov.au/statistics/pbs_item.shtml. Accessed Nov 2012

Wonder how many other medical interactions/costs also decreased in Australia due to the huge increase in vitamin D
It appears that the wholesale cost of the 3kg of vitamin D (for the entire country of Australia) is less than $100,000

20X increase in vitamin D sold and 36 percent decrease in osteoporosis business in Australia – Nov 2013        

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