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France restricts Vitamin D testing to 4 health problems, paper proposes 5 more – Nov 2016

French law: what about a reasoned reimbursement of serum vitamin D assays?

Geriatr Psychol Neuropsychiatr Vieil. 2016 Nov 4. [Epub ahead of print]

Souberbielle JC1, Benhamou CL2, Cortet B3, Rousière M4, Roux C5, Abitbol V6, Annweiler C7, Audran M8, Bacchetta J9, Bataille P10, Beauchet O7, Bardet R11, Benachi A12, Berenbaum F13, Blain H14, Borson-Chazot F15, Breuil V16, Briot K5, Brunet P17, Carel JC18, Caron P19, Chabre O20, Chanson P21, Chapurlat R22, Cochat P9, Coutant R23, Christin-Maitre S24, Cohen-Solal M25, Combe C26, Cormier C27, Courbebaisse M28, Debrus G29, Delemer B30, Deschenes G31, Duquenne M32, Duval G7, Fardellone P33, Fouque D34, Friedlander G35, Gauvain JB36, Groussin L37, Guggenbuhl P38, Houillier P28, Hannedouche T39, Jacot W40, Javier RM41, Jean G42, Jeandel C43, Joly D44, Kamenicky P21, Knebelmann B44, Lafage-Proust MH45, LeBouc Y46, Legrand E8, Levy-Weil F47, Linglart A48, Machet L49, Maheu E4, Mallet E50, Marcelli C51, Marès P52, Mariat C53, Maruani G28, Maugars Y54, Montagnon F55, Moulin B39, Orcel P25, Partouche H56, Personne V56, Pierrot-Deseilligny C57, Polak M58, Pouteil-Noble C59, Prié D1, Raynaud-Simon A60, Rolland Y61, Sadoul JL62, Salle B63, Sault C64, Schott AM65, Sermet-Gaudelus I66, Soubrier M67, Tack I68, Thervet E69, Tostivint I70, Touraine P71, Tremollières F72, Urena-Torres P73, Viard JP74, Wemeau JL75, Weryha G76, Winer N77, Young J21, Thomas T45.

The number of serum 25-hydroxyvitamin D (25OHD) assays has increased tenfold in France in less than 10 years, sometimes for invalidated reasons. In 2013, the French National Authority for Health (Haute autorité de santé, or HAS) limited the indications for serum 25OHD measurements to

  1. rickets/osteomalacia,
  2. older adults with recurrent falls,
  3. monitoring of kidney transplant in adults, and
  4. surgical treatment of obesity in adults.

Our aim here was to note that other indications for serum 25OHD measurements are supported by previous literature and by a number of national and international recommendations, in particular the following:

  1. any situation of bone fragility,
  2. any chronic renal failure <45 mL/min/1.73m2,
  3. any situation of malabsorption,
  4. clinical signs consistent with vitamin D deficiency or vitamin D overload, and
  5. calcium phosphorus evaluation.

We suggest that the measurement of serum 25OHD concentration should remain reimbursed as part of these extended indications.

PMID: 27818369 DOI: 10.1684/pnv.2016.0631 (DOI did not work in early Nov 2016)

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