Cost-effectiveness of vitamin D 3 supplementation in older adults with vitamin D deficiency in Ireland

Laurence Francis Lacey, David J Armstrong, Emily Royle, Pamela Magee, L Kirsty Pourshahidi, Sumantra Ray, J J Strain, Emeir McSorley

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Abstract

Background This study investigated the cost-effectiveness of vitamin D3 supplementation in older adults in Ireland, with year-round vitamin D deficiency (serum 25-hydroxyvitamin D concentration <30 nmol/L) (13% of Irish adults), from the perspective of the Health Service Executive.

Methods Three age groups were investigated: (1) ≥50 years, (2) ≥60 years and (3) ≥70 years. Based on the clinical literature, vitamin D3 supplementation may: (1) decrease all-cause mortality by 7% and (2) reduce hip fractures by 16% and non-hip fractures by 20%. A discount rate of 4% was applied to life years and quality-adjusted life years (QALYs) gained, and healthcare costs. The annual healthcare costs per patient used in the model are based on the average annual health resource use over the 5-year time horizon of the model.

Results The cost/QALY estimates in all three age groups are below the usually acceptable cost-effectiveness threshold of €20 000/QALY. The most cost-effective and least costly intervention was in adults ≥70 years. For this age group, the average annual costs and outcomes would be approximately €5.6 million, 1044 QALYs gained, with a cost/QALY of approximately €5400. The results are most sensitive to the mortality risk reduction following vitamin D3 supplementation.

Conclusion The cost-effectiveness of vitamin D3 supplementation is most robust in adults ≥70 years. Clinical uncertainty in the magnitude of the benefits of vitamin D3 supplementation could be further addressed by means of: (1) performing a clinical research study or (2) conducting a pilot/regional study, prior to reaching a decision to invest in a nationwide programme.
Original languageEnglish
Article number000382
Pages (from-to)1-8
Number of pages8
JournalBMJ Nutrition, Prevention & Health
DOIs
Publication statusPublished - 26 May 2022

Keywords

  • Original research
  • 1506
  • nutrient deficiencies
  • nutrition assessment
  • nutritional treatment

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