Toggle Health Problems and D

UK would save as least 636 million dollars annually by giving 800 IU vitamin D free to all seniors – June 2014

Note: 2 publications on this page by the same authors:
#1 is behind a paywall,
#2 is free

VitaminDWiki: Cost of Vitamin D capsules

10,000 IU capsules 5 cents each on Amazon (1 bottle would last 7 years)
Only need take one capsule per week (5cents) = 1430 IU (>800 IU)
Put 4 capsules in jar at beginning of the month, and take one each SUNday
Take all of remaining capsules at the end of the month.
$3 for vitamin D for entire year

The short-term impact of vitamin D-based hip fracture prevention in older adults in the United Kingdom (pub #1)

J Endocrinol Invest. 2014 Jun 24. [Epub ahead of print]
Poole CD1, Smith JC, Davies JS. daviesjs at cf.ac.uk
Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK.

PURPOSE: Vitamin D is a relatively inexpensive drug yet an important hormone in terms of calcium and bone homeostasis. Treatment with vitamin D is associated with reduced fracture risk particularly in an elderly population. Therefore, we assessed the budgetary impact of routine prescription of 800 IU daily colecalciferol on hip fracture among older adults in the United Kingdom.

METHODS: Using meta-analysis findings for treatment effect and UK-estimates of incidence, we performed a health economic evaluation of treating the UK population aged 65 and over with 800 IU of vitamin D daily, assessing the impact upon hip fracture costs using incremental attributable costs and excess mortality for a range of age- gender-based treatment strategies.

RESULTS: Using only a 1-year horizon, considering only reduction in hip fracture, prescribing colecalciferol 800 IU daily to all adults aged 65 and over, could reduce the number of incident hip fractures from 65,400 to 45,700, saving almost 1,700 associated deaths, whilst saving the UK taxpayer £22 million.

CONCLUSIONS: As the UK government seeks to reduce public expenditure in all sectors, investment in prescribed prophylactic colecalciferol 800 IU therapy for adults aged 65 and over is likely to yield cost savings through reduction hip fracture alone in the first year.

PMID: 24957166

Same authors, pub #2 - Sept 2015

Cost-effectiveness and budget impact of Empirical vitamin D therapy on unintentional falls in older adults in the UK

 Download the PDF from VitaminDWiki

Age Pounds
$ Saved
60+420 M$636 M
75+2,056 M$3,116 M

Thus saving $3 Billion if just give 800 IU to those who fall a lot (> age 75)

Comments on publication #1

Would save much more money if

  1. Used higher dose of vitamin D - 800 IU is barely enough to make a difference
  2. Consider benefits to other health problems of seniors: example vertebral fracture
  3. Give an even higher dose to those seniors who are especially at high risk of being vitamin D deficient
    shut-in, dark skin, overweight, avoid the sun due to fear of skin cancer, etc.
  4. Include cofactors for strong bones: Magnesium for example (see below)

Suspect that the study assumed 100% compliance - vs typical compliance is only about 30%

Appears that the study did not include education nor distribution costs for the vitamin D (see Table 1)

Publisher wants $40 for the PDF

See also VitaminDWiki

Meta-analysis of Falls and Fracture in VitaminDWiki

Pages listed in BOTH Falls/Fracture and Cost Savings

References - pub #1

  • Mellanby E (1976) Nutrition Classics. The Lancet 1:407-12, 1919. An experimental investigation of rickets. Edward Mellanby. Nutr Rev 34:338–340 CrossRef
  • Norman AW (2008) From vitamin D to hormone D: fundamentals of the vitamin D endocrine system essential for good health. Am J Clin Nutr 88:491S–499S CrossRef
  • Darling AL, Hart KH, Macdonald HM et al (2013) Vitamin D deficiency in UK South Asian Women of childbearing age: a comparative longitudinal investigation with UK Caucasian women. Osteoporos Int 24:477–488 CrossRef
  • Hyppönen E, Power C (2007) Hypovitaminosis D in British adults at age 45 year: nationwide cohort study of dietary and lifestyle predictors. Am J Clin Nutr 85:860–868
  • Schöttker B, Haug U, Schomburg L et al (2013) Strong associations of 25-hydroxyvitamin D concentrations with all-cause, cardiovascular, cancer, and respiratory disease mortality in a large cohort study. Am J Clin Nutr 25:782–793 CrossRef
  • Pearce SH, Cheetham TD (2010) Diagnosis and management of vitamin D deficiency. BMJ 340:b5664 CrossRef
  • Lee HJ, Gong HS, Song CH et al (2013) Evaluation of vitamin D level and grip strength recovery in women with a distal radius fracture. J Hand Surg Am 38:519–525 CrossRef
  • Diamond T, Wong YK, Golombick T (2013) Effect of oral cholecalciferol 2,000 versus 5,000 IU on serum vitamin D, PTH, bone and muscle strength in patients with vitamin D deficiency. Osteoporos Int 24:1101–1105 CrossRef
  • Dhesi JK, Jackson SHD, Bearne LM et al (2004) Vitamin D supplementation improves neuromuscular function in older people who fall. Age Ageing 33:589–595 CrossRef
  • Muir SW, Montero-Odasso M (2011) Effect of vitamin D supplementation on muscle strength, gait and balance in older adults: a systematic review and meta-analysis. J Am Geriatr Soc 59:2291–2300 CrossRef
  • Murad MH, Elamin KB, Abu Elnour NO et al (2011) Clinical review: The effect of vitamin D on falls: a systematic review and meta-analysis. J Clin Endocrinol Metab 96:2997–3006 CrossRef
  • Cameron ID, Gillespie LD, Robertson MC et al (2012) Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev 12:CD005465
  • Bischoff-Ferrari HA, Willett WC, Orav EJ et al (2012) A pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med 367:40–49 CrossRef
  • Davies SC, Jewell T, McBride M, et al. VITAMIN D–ADVICE ON SUPPLEMENTS FOR AT RISK GROUPS. London: Department of Health 2012. https://www.gov.uk/government/publications/vitamin-d-advice-on-supplements-for-at-risk-groups
  • Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB et al (2009) Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials. BMJ 339:b3692 CrossRef
  • Office for National Statistics (2011) Mortality figures for United Kingdom. http://www.statistics.gov.uk/hub/population/deaths/mortality-rates. (Accessed 14 Apr 2013)
  • NHSBSA Prescription Services. Electronic Drug Tariff. http://www.ppa.org.uk/ppa/edt_intro.htm. (Accessed 14 Apr 2014)
  • Collins GS, Mallett S, Altman DG (2011) Predicting risk of osteoporotic and hip fracture in the United Kingdom: prospective independent and external validation of Q fracture scores. BMJ 342:d3651 CrossRef
  • Baker NL, Cook MN, Arrighi HM et al (2011) Hip fracture risk and subsequent mortality among Alzheimer’s disease patients in the United Kingdom, 1988–2007. Age Ageing 40:49–54 CrossRef
  • Parrott S. The Economic Cost of Hip Fracture in the UK. York: 00. http://webarchive.nationalarchives.gov.uk/+/http://www.berr.gov.uk/files/file21463.pdf
  • HM Treasury (2012) 2012 GDP deflators.http://www.hm-treasury.gov.uk/data_gdp_index.htm. (Accessed 29 Mar 2013)
  • Nikitovic M, Wodchis WP, Krahn MD et al (2013) Direct health-care costs attributed to hip fractures among seniors: a matched cohort study. Osteoporos Int 24:659–669 CrossRef
  • XE.com (2013) XE currency conversion. http://www.xe.com/ucc/convert/?Amount=37575&From=CAD&To=GBP. (Accessed 14 Apr 2013)
  • Kanis JA, Oden A, Johnell O et al (2003) The components of excess mortality after hip fracture. Bone 32:468–473 CrossRef
  • Office for National Statistics (2012) Death Registrations Summary Tables–England and Wales, 2011 (Final). http://www.ons.gov.uk/ons/rel/vsob1/death-reg-sum-tables/2011-final-/index.html. (Accessed 14 May 2013)
  • Woolf AD, Akesson K (2003) Preventing fractures in elderly people. BMJ 327:89–95 CrossRef
  • MHRA. Off-label or unlicensed use of medicines: prescribers’ responsibilities. http://www.mhra.gov.uk/Safetyinformation/DrugSafetyUpdate/CON087990. (Accessed 14 Apr 2013)
  • Leblanc ES, Perrin N, Johnson JD et al (2013) Over-the-counter and compounded vitamin D: is potency what we expect? JAMA Intern Med 173:585–586 CrossRef
  • Garg S, Sabri D, Kanji J et al (2013) Evaluation of vitamin D medicines and dietary supplements and the physicochemical analysis of selected formulations. J Nutr Health Aging 17:158–161 CrossRef
  • British Orthopaedic Association (2007) The care of patients with fragility fracture. http://www.bgs.org.uk/pdf_cms/pubs/Blue%20Book%20on%20fragility%20fracture%20care.pdf. Accessed 14 Apr 2014
  • Bebbington A, Darton R, Netten A. Elderly people admitted to residential and nursing homes: 42 months on 2000. http://www.pssru.ac.uk/pdf/p051.pdf
  • Gutiérrez L, Roskell N, Castellsague J et al (2012) Clinical burden and incremental cost of fractures in postmenopausal women in the United Kingdom. Bone 51:324–331 CrossRef
  • Holt G, Smith R, Duncan K et al (2008) Epidemiology and outcome after hip fracture in the under 65 s-evidence from the Scottish hip fracture audit. Injury 39:1175–1181 CrossRef
  • Gunasekera N, Boulton C, Morris C et al (2010) Hip fracture audit: the Nottingham experience. Osteoporos Int 21:S647–S653 CrossRef
  • Autier P, Gandini S (2007) Vitamin D supplementation and total mortality: a meta-analysis of randomized controlled trials. Arch Intern Med 167:1730–1737 CrossRef
  • Bjelakovic G, Gluud LL, Nikolova D et al (2011) Vitamin D supplementation for prevention of mortality in adults. Cochrane Database Syst Rev 7:CD007470
  • Grey A, Bolland M, Reid I (2012) Vitamin D dose requirements for fracture prevention. N Engl J Med 367:1367–1370 CrossRef
  • Gibson S (2001) Dietary sugars and micronutrient dilution in normal adults aged 65 years and over. Public Health Nutr 4:1235–1244 CrossRef
  • Bolland MJ, Grey A, Avenell A et al (2011) Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis. BMJ 342:d2040 CrossRef
  • British Medical Association, Royal Pharmaceutical Society (2013) British National Formulary. 65th edn. BMJ Publishing & Pharmaceutical Press 2013. http://www.bnf.org
UK would save as least 636 million dollars annually by giving 800 IU vitamin D free to all seniors – June 2014        
9324 visitors, last modified 29 Sep, 2015,
(Cached) Printer Friendly Follow this page for updates

Attached files

ID Name Comment Uploaded Size Downloads
5994 800 T6.jpg admin 29 Sep, 2015 38.08 Kb 843
5993 800 T5.jpg admin 29 Sep, 2015 34.87 Kb 836
5991 800 T2.jpg admin 29 Sep, 2015 57.03 Kb 933
5989 800 IU falls.pdf admin 29 Sep, 2015 884.32 Kb 1168
4085 Hip T1.jpg admin 28 Jun, 2014 47.08 Kb 1254