Poole Chris D, Smith Jamie C, Davies J Stephen
Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK.
J Endocrinol Invest. 2014 Sep;37(9):811-7. doi: 10.1007/s40618-014-0109-2. Epub 2014 Jun 24.
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.
维生素D是一种相对便宜的药物，但却是钙和骨内环境稳定方面的重要激素。维生素D治疗与骨折风险降低相关，尤其是在老年人群中。因此，我们评估了英国老年人每日常规服用800国际单位骨化醇对髋部骨折的预算影响。
利用荟萃分析得出的治疗效果以及英国的发病率估计值，我们对英国65岁及以上人群每日服用800国际单位维生素D进行了健康经济评估，采用一系列基于年龄和性别的治疗策略，通过增量归因成本和超额死亡率评估对髋部骨折成本的影响。
仅以1年为时间跨度，仅考虑髋部骨折减少情况，对所有65岁及以上成年人每日开具800国际单位骨化醇处方，可使髋部骨折发生率从65400例降至45700例，避免近1700例相关死亡，同时为英国纳税人节省2200万英镑。
由于英国政府试图削减所有部门的公共开支，对65岁及以上成年人进行规定的预防性800国际单位骨化醇治疗投资，仅在第一年通过减少髋部骨折就可能节省成本。
