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Changing patterns of prescription in vitamin D supplementation in adults: analysis of a regional dataset

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Abstract

Summary

Scientific interest in vitamin D has greatly risen during the last 10 years. The analysis of the changes in vitamin D prescriptions and related costs in a regional prescription dataset has revealed a profound increase in the period 2006–2013. Further studies on cost-effectiveness of such increase in vitamin D supplementation are needed.

Introduction

The aim of this study was to analyze the changes in population-based prescription patterns of vitamin D supplements in the general population in an Italian regional setting during an 8-year period (2006–2013).

Methods

Data have been retrieved from the database of reimbursed prescriptions of the Region of Tuscany containing all of the medical reimbursements for the whole regional population (total of 3,619,872 and 3,692,828 inhabitants in 2006 and 2013, respectively). Data referring to adult population (age 20–90+ years) have been considered for this analysis (3,033,530 in 2006 and 3,066,741 in 2013). Two different flows (pharmaceutical distribution dataset and general data flow) were taken into account, using the ATC5 coding system for vitamin D supplements alone or in combination with calcium or alendronate. The number of boxes dispensed was retrieved, the number of patients receiving a specific treatment was calculated, and a cost analysis was performed.

Results

An upsurge in the prescriptions of vitamin D compounds was disclosed, mainly sustained by a 75.3-fold increase in cholecalciferol, in all age groups and both sexes. This occurred in parallel to a 4.3-fold rise in prescriptions of oral alendronate in combination with cholecalciferol, a slight decrease in dispensed alendronate alone, and a modest increase in the prescription of the combination of calcium salts and cholecalciferol, and calcium alone. The total cost for reimbursement by the Regional Health System for vitamin D-related compounds rose from €3,242,100 euros in 2006 to €8,155,778 in 2013.

Conclusion

The huge increase in vitamin D prescriptions and related costs in the last decade, as revealed by the analysis of a regional pharmaceutical dataset, reflects the increased awareness of the possible consequences of a poor vitamin D status. Further studies on cost-effectiveness of such increase in vitamin D supplementation are needed.

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References

  1. van Schoor NM, Lips P (2011) Worldwide vitamin D status. Best Pract Res Clin Endocrinol Metab 25:671–680

    Article  PubMed  Google Scholar 

  2. Institute of Medicine (IOM) (2011) Dietary reference intakes for calcium and vitamin D. National Academies Press, Washington, DC

    Google Scholar 

  3. Holick MF, Binkley NC, Bischoff-Ferrari HA et al (2012) Guidelines for preventing and treating vitamin D deficiency and insufficiency revisited. J Clin Endocrinol Metab 97:1153–1158

    Article  CAS  PubMed  Google Scholar 

  4. Rizzoli R, Boonen S, Brandi ML et al (2013) Vitamin D supplementation in elderly or postmenopausal women: a 2013 update of the 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Curr Med Res Opin 29:305–313

    Article  CAS  PubMed  Google Scholar 

  5. Gallagher JC, Yalamanchili V, Smith LM (2013) The effect of vitamin D supplementation on serum 25(OH)D in thin and obese women. J Steroid Biochem Mol Biol 136:195–200

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Guidelines on prevention and treatment of vitamin D deficiency. Italian Adami S, Romagnoli E, Carnevale V, et al.; Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS) (2011) Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS)]. Reumatismo 63:129–147

  7. Cianferotti L, Brandi ML (2012) Guidance for the diagnosis, prevention and therapy of osteoporosis in Italy. Clin Cases Miner Bone Metab 9:170–178

    PubMed Central  PubMed  Google Scholar 

  8. Koutkia P, Chen TC, Holick MF (2001) Vitamin D intoxication associated with an over-the-counter supplement. N Engl J Med 345:66–67

    Article  CAS  PubMed  Google Scholar 

  9. Sanders KM, Nicholson GC, Ebeling PR (2013) Is high dose vitamin D harmful? Calcif Tissue Int 92:191–206

    Article  CAS  PubMed  Google Scholar 

  10. Ringe JD (2012) The effect of vitamin D on falls and fractures. Scand J Clin Lab Invest Suppl 243:73–78

    PubMed  Google Scholar 

  11. Bruyère O, Cavalier E, Souberbielle JC et al (2014) Effects of vitamin D in the elderly population: current status and perspectives. Arch Public Health 72:32

    Article  PubMed Central  PubMed  Google Scholar 

  12. Bouillon R, Van Schoor NM, Gielen E et al (2013) Optimal vitamin D status: a critical analysis on the basis of evidence-based medicine. J Clin Endocrinol Metab 98:E1283–E1304

    Article  CAS  PubMed  Google Scholar 

  13. Theodoratou E, Tzoulaki I, Zgaga L et al (2014) Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials. BMJ 348:g2035

    Article  PubMed Central  PubMed  Google Scholar 

  14. Research and Market’s report: Global Vitamin D Testing Market, http://www.researchandmarkets.com/reports/2686213/

  15. Sattar N, Welsh P, Panarelli M et al (2012) Increasing requests for vitamin D measurement: costly, confusing, and without credibility. Lancet 379:95–96

    Article  PubMed  Google Scholar 

  16. Caillet P, Souberbielle JC, Jaglal SB et al (2013) Vitamin D supplementation in a healthy, middle-aged population: actual practices based on data from a French comprehensive regional health-care database. Eur J Clin Nutr 67:1133–1137

    Article  CAS  PubMed  Google Scholar 

  17. Caillet P, Jaglal SB, Laforest L et al (2014) Impact of vitamin D supplementation on health-care use in a 25-hydroxyvitamin D-tested population in France: a population-based descriptive cohort study. Public Health Nutr Mar 31:1–11

    Google Scholar 

  18. Piscitelli P, Marcucci G, Parri S et al (2011) Compliance to antifracture treatments in Tuscany: a regional survey based on institutional pharmaceutical dataset. Clin Cases Miner Bone Metab 8:62–65

    PubMed Central  PubMed  Google Scholar 

  19. Ross MK, Wei W, Ohno-Machado L (2014) “Big data” and the electronic health record. Yearb Med Inform 9:97–104

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Demonceau J, Ruppar T, Kristanto P et al (2013) Identification and assessment of adherence-enhancing interventions in studies assessing medication adherence through electronically compiled drug dosing histories: a systematic literature review and meta-analysis. Drugs 73:545–562

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Cianferotti L, Marcocci C (2012) Subclinical vitamin D deficiency. Best Pract Res Clin Endocrinol Metab 26:523–537

    Article  CAS  PubMed  Google Scholar 

  22. Li K, Kaaks R, Linseisen J, Rohrmann S (2012) Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study (EPIC-Heidelberg). Heart 98:920–925

    Article  CAS  PubMed  Google Scholar 

  23. Bolland MJ, Grey A, Reid IR (2013) Calcium supplements and cardiovascular risk: 5 years on. Ther Adv Drug Saf 4:199–210

    Article  PubMed Central  PubMed  Google Scholar 

  24. Kim SY (2013) The pleiomorphic actions of vitamin D and its importance for children. Ann Pediatr Endocrinol Metab 18:45–54

    Article  PubMed Central  PubMed  Google Scholar 

  25. Abrams SA, Coss-Bu JA, Tiosano D (2013) Vitamin D: effects on childhood health and disease. Nat Rev Endocrinol 9:162–170

    Article  CAS  PubMed  Google Scholar 

  26. Hanley DA, Zhang Q, Meilleur MC, Mavros P, Sen SS (2007) Prescriptions for vitamin D among patients taking antiresorptive agents in Canada. Curr Med Res Opin 23:1473–1480

    Article  CAS  PubMed  Google Scholar 

  27. Zhou W, Langsetmo L, Berger C et al (2013) Longitudinal changes in calcium and vitamin D intakes and relationship to bone mineral density in a prospective population-based study: the Canadian Multicentre Osteoporosis Study (CaMos). J Musculoskelet Neuronal Interact 13:470–479

    CAS  PubMed  Google Scholar 

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Conflicts of interest

L. Cianferotti, S. Parri, G. Gronchi, C. Rizzuti C. Fossi declares that they have no conflict of interest. D. M. Black declares to have received consultant and speaking fees and grants from: Amgen, Eli Lilly, MSD, Novartis, Roche and Servier. M. L. Brandi declares to have received consultant and speaking fees in the last one year from: Merck, Novartis, Amgen, Radius.

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Authors and Affiliations

  1. Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy

    L. Cianferotti, S. Parri, G. Gronchi, C. Rizzuti, C. Fossi, D. M. Black & M. L. Brandi

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  1. L. Cianferotti
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  2. S. Parri
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  3. G. Gronchi
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  4. C. Rizzuti
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  5. C. Fossi
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  6. D. M. Black
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  7. M. L. Brandi
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Corresponding author

Correspondence to M. L. Brandi.

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Cianferotti, L., Parri, S., Gronchi, G. et al. Changing patterns of prescription in vitamin D supplementation in adults: analysis of a regional dataset. Osteoporos Int 26, 2695–2702 (2015). https://doi.org/10.1007/s00198-015-3187-x

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  • DOI: https://doi.org/10.1007/s00198-015-3187-x

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