The short-term impact of vitamin D-based hip fracture prevention in older adults in the United Kingdom
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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.
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.
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.
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.
KeywordsVitamin D Hip fracture Health economics Colecalciferol Mortality Elderly care
Conflict of interest
Dr Poole has previously consulted for Internis Pharmaceuticals (manufacturer of Fultium-D3), Astellas and Norgine. Dr Davies is a medical advisor to Internis Pharmaceuticals and has undertaken consultancy work for Meda (Manufacturer of Desunin) and Prostrakan (manufacturers of Adcal-D3). Dr Smith has nothing to disclose.
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