Cost-effectiveness of vitamin D3 supplementation in older adults with vitamin D deficiency in Ireland.

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
ACS Applied Electronic Materials Pub Date : 2022-05-26 eCollection Date: 2022-01-01 DOI:10.1136/bmjnph-2021-000382
Laurence Francis Lacey, David J Armstrong, Emily Royle, Pamela Magee, L Kirsty Pourshahidi, Sumantra Ray, J J Strain, Emeir McSorley
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引用次数: 1

Abstract

Background: This study investigated the cost-effectiveness of vitamin D3 supplementation in older adults in Ireland, with year-round vitamin D deficiency (serum 25-hydroxyvitamin D concentration <30 nmol/L) (13% of Irish adults), from the perspective of the Health Service Executive.

Methods: Three age groups were investigated: (1) ≥50 years, (2) ≥60 years and (3) ≥70 years. Based on the clinical literature, vitamin D3 supplementation may: (1) decrease all-cause mortality by 7% and (2) reduce hip fractures by 16% and non-hip fractures by 20%. A discount rate of 4% was applied to life years and quality-adjusted life years (QALYs) gained, and healthcare costs. The annual healthcare costs per patient used in the model are based on the average annual health resource use over the 5-year time horizon of the model.

Results: The cost/QALY estimates in all three age groups are below the usually acceptable cost-effectiveness threshold of €20 000/QALY. The most cost-effective and least costly intervention was in adults ≥70 years. For this age group, the average annual costs and outcomes would be approximately €5.6 million, 1044 QALYs gained, with a cost/QALY of approximately €5400. The results are most sensitive to the mortality risk reduction following vitamin D3 supplementation.

Conclusion: The cost-effectiveness of vitamin D3 supplementation is most robust in adults ≥70 years. Clinical uncertainty in the magnitude of the benefits of vitamin D3 supplementation could be further addressed by means of: (1) performing a clinical research study or (2) conducting a pilot/regional study, prior to reaching a decision to invest in a nationwide programme.

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爱尔兰维生素D缺乏症老年人补充维生素D3的成本效益
背景:本研究调查了爱尔兰老年人补充维生素D3的成本-效果,这些老年人全年缺乏维生素D(血清25-羟基维生素D浓度)。方法:研究了三个年龄组:(1)≥50岁,(2)≥60岁和(3)≥70岁。根据临床文献,补充维生素D3可以:(1)降低7%的全因死亡率;(2)降低16%的髋部骨折和20%的非髋部骨折。对获得的生命年和质量调整生命年(QALYs)以及医疗保健费用采用4%的贴现率。模型中使用的每位患者的年度医疗保健费用基于模型5年时间范围内的平均年度医疗资源使用量。结果:所有三个年龄组的成本/质量aly估计都低于通常可接受的成本效益阈值20,000欧元/质量aly。最具成本效益和成本最低的干预措施是针对≥70岁的成年人。对于这一年龄组,平均每年的成本和结果约为560万欧元,获得1044个质量aly,成本/质量aly约为5400欧元。结果对补充维生素D3后死亡率风险的降低最为敏感。结论:在≥70岁的成年人中,补充维生素D3的成本-效果最为显著。补充维生素D3益处程度的临床不确定性可以通过以下方式进一步解决:(1)进行临床研究或(2)在决定投资全国计划之前进行试点/区域研究。
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来源期刊
CiteScore
7.20
自引率
4.30%
发文量
567
期刊介绍: ACS Applied Electronic Materials is an interdisciplinary journal publishing original research covering all aspects of electronic materials. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials science, engineering, optics, physics, and chemistry into important applications of electronic materials. Sample research topics that span the journal's scope are inorganic, organic, ionic and polymeric materials with properties that include conducting, semiconducting, superconducting, insulating, dielectric, magnetic, optoelectronic, piezoelectric, ferroelectric and thermoelectric. Indexed/​Abstracted: Web of Science SCIE Scopus CAS INSPEC Portico
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