Professor Dr. Theodor Sproll, Duale Hochschule Baden-Württemberg, Loerrach, Germany.
“Medical evidence on positive outcomes of fighting vitamin D deficiency has risen significantly in the past years. Results of several global meta-analyses indicate desired medical benefits beyond osteoporosis, e.g., cardiovascular diseases, diabetes, infectious diseases, cancer and other indications. The strongest clinical case, however, can be made for the vitamin D deficiency and outcomes in osteoporosis-related consequences for the elderly. Overall, an estimated 60% of the German population, according to research of the Robert Koch Institute, do not have sufficient vitamin D levels.
In this context, expenditures for health care, especially spending for the elderly, has become an issue of highest importance. On average EU countries spent 9.0% of Gross National Product (GNP) for health care in 2008. Health care spending for the age group 65–84 years is 2.5 times that of average health care spending, and 20% of the population account for 80% of spending that goes to care for people with chronic conditions. The sustainability of financing health care is the primary concern for European policy decision makers.
Research on the socioeconomic consequences of vitamin D deficiency is growing, and a number of studies published to date indicate a significant cost saving potential for European health care systems if the issue of vitamin D deficiency were to be addressed and solved effectively. Based on global research and 2008 data, the cost saving potential can be extrapolated to reach €165 billion for 17 countries in Europe. For the US, the corresponding cost reduction could amount to €280 million.
A research paper on the results of a Budget Impact Model from February 2011 on 'vitamin D deficiency and socioeconomic costs' (1) evaluates the effects of a potential vitamin D supplementation policy and the costs and benefits within the German hospital setting. Hip and vertebral fractures, the most cost intense medical implications in treating osteoporosis in hospitals, were analyzed: as expected the outcome was a reduction in the number of hip and vertebral fractures. Based on 2008 data, an optimized vitamin D status would result in 5,478 less hip fractures and in 18,420 less vertebral fractures. As foreseen in the context of the German Diagnosis Related Group system, the savings in avoiding fractures are compensated when the focus is only on direct costs. But when taking the medical and therapeutic costs for osteoporosis prevention and treatment and other indirect costs into account, the savings are expected to compensate supplementation costs. The research paper’s findings point to a net socioeconomic benefit. When costs are integrated and low-price supplementation is modelled, savings of anywhere from €585 million up to €780 million can be predicted for the osteoporosis-diagnosed population in Germany in 2008.
As a conclusion, addressing the vitamin D deficiency issue is – next to the medical dimension – also from an economic perspective, an important political and educational task. The cost saving potential for European health care systems is significant. 'Health maintenance' should substitute current 'health repair' approach to treatment and a long-term perspective is required versus short-term policies. A diagnostic tool kit for physicians is needed to assist in better identifying the osteoporosis risk population and allowing selection of these patients, for whom treatment would be the most cost-efficient.”
Brussels, Belgium, March 2011