Costs of vitamin D testing and prescribing among children in primary care
European Journal of Pediatrics. pp 1–5, First Online: 12 August 2017, doi:10.1007/s00431-017-2986-9
Vitamin D has attracted considerable interest in recent years, with a marked increase in diagnosis of vitamin D deficiency seen among children in clinical practice in the UK. The economic implications of this change in diagnostic behaviour have not been explored. We performed a cohort study to examine longitudinal trends in healthcare expenditure arising from vitamin D testing and prescribing for children in primary care in England, using the electronic healthcare records of __722,525 children aged 0–17 years_ held in The Health Improvement Network database.
Combined costs of vitamin D tests and prescriptions increased from
- £1647 per 100,000 person-years in 2008 (95% CI, £934 to £3007) to
- £28,913 per 100,000 person-years in 2014 (95% CI, £26,361 to £31,739).
The total cost of vitamin D prescriptions and tests for children in primary care at the national level in England in 2014 was estimated to be £4.31 million (95% CI, £2.96–£6.48 million).
Conclusion: There has been a marked increase in healthcare expenditure on vitamin D tests and prescriptions for children in primary care over the past decade. Future research should explore the drivers for this change in diagnostic behaviour and the reasons prompting investigation of vitamin D status in clinical practice.
What is Known:
• Vitamin D deficiency has attracted considerable interest in recent years, with a marked increase in diagnosis seen in children.
• The economic implications of this change in diagnostic behaviour have not been explored.
What is New:
• There has been a large increase in healthcare expenditure on vitamin D tests and prescriptions for children in primary care in England over the past decade (> 15 fold between 2008 and 2013).
• Screening of vitamin D status in children without specific risk factors or clinical features of deficiency may represent avoidable healthcare expenditure.
722,000 Children
Vitamin D testing and prescriptions is still < 0.3 £/child-year
Mainly because they give such small doses of Vitamin D
UK incorrectly believes that 10 ng of Vitamin D is enough.
Small doses are indeed enough if the goal is to get only to 10ng_
- UK proposes that 10 ng level and 400 IU is enough Vitamin D for everybody (no and no)- July 2015
- Post-mortem analysis of children in London Hospital – only 1 child had adequate level of vitamin D – July 2014
This UK Study defined adequate as > 32 ng, NOT just 10 ng - Is 50 ng of vitamin D too high, just right, or not enough which is 5X higher than UK goal