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BMJ Open. 2015 Sep 29;5(9):e007910. doi: 10.1136/bmjopen-2015-007910.

Cost-effectiveness and budget impact of Empirical vitamin D therapy on unintentional falls in older adults in the UK.

Author information

1
Cochrane Institute for Primary Care & Public Health, Cardiff University, Cardiff, UK.
2
Torbay General Hospital, Torquay, Devon, UK.
3
Centre for Diabetes and Endocrinology, University Hospital of Wales, Cardiff, UK.

Abstract

OBJECTIVES:

To evaluate the health outcomes and economics associated with the current guidance relating to the prevention of falls in the elderly through vitamin D supplementation.

SETTING:

UK.

PARTICIPANTS:

UK population aged 60 years and above.

INTERVENTIONS:

A Markov health state transition model simulated patient transitions between key fall-related outcomes using a 5-year horizon and annual cycles to assess the costs and benefits of empirical treatment with colecalciferol 800 iu daily.

PRIMARY AND SECONDARY OUTCOME MEASURES:

Costs and health outcomes attributable to fall prevention following vitamin D supplementation.

RESULTS:

Our model shows that treating the UK population aged 60 years and above with 800 iu colecalciferol would, over a 5-year period: (1) prevent in excess of 430,000 minor falls; (2) avoid 190,000 major falls; (3) prevent 1579 acute deaths; (4) avoid 84,000 person-years of long-term care and (5) prevent 8300 deaths associated with increased mortality in long-term care. The greatest gains are seen among those 75 years and older. Based on reduction in falls alone, the intervention in all adults aged 65+ is cost-saving and leads to increased quality adjusted life years. Treating all adults aged 60+ incurs an intervention cost of £2.70bn over 5 years, yet produces a -£3.12bn reduction in fall-related costs; a net saving of £420M. Increasing the lower bound age limit by 5-year increments increases budget impact to -£1.17bn, -£1.75bn, and -£2.06bn for adults 65+, 70+ and 75+, respectively.

CONCLUSIONS:

This study shows that treatment of the elderly UK population with colecalciferol 800 iu daily would be associated with reductions in mortality and substantial cost-savings through fall prevention.

KEYWORDS:

GERIATRIC MEDICINE; HEALTH ECONOMICS

PMID:
26419680
PMCID:
PMC4593147
DOI:
10.1136/bmjopen-2015-007910
[Indexed for MEDLINE]
Free PMC Article

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