Comparison of Cost-Effectiveness of Vitamin D Screening with That of Universal Supplementation in Preventing Falls in Community-Dwelling Older Adults
Article first published online: 30 APR 2013
© 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 61, Issue 5, pages 707–714, May 2013
How to Cite
Lee, R. H., Weber, T. and Colón-Emeric, C. (2013), Comparison of Cost-Effectiveness of Vitamin D Screening with That of Universal Supplementation in Preventing Falls in Community-Dwelling Older Adults. Journal of the American Geriatrics Society, 61: 707–714. doi: 10.1111/jgs.12213
- Issue published online: 14 MAY 2013
- Article first published online: 30 APR 2013
- vitamin D;
- accidental falls
To compare the cost-effectiveness of population screening for vitamin D insufficiency with that of universal vitamin D supplementation in community-dwelling older adults.
A Markov decision model simulating follow-up over a 36-month period. Published data were used to estimate values for the model, including costs (measured in 2011 U.S. dollars), utilities (measured in quality-adjusted life years (QALYs)), and probabilities.
Decision analysis simulation from a societal perspective.
Hypothetical cohort of community-dwelling women and men aged 65 to 80.
Net monetary benefit (NMB) was calculated by subtracting the incremental cost of the strategy from the product of incremental QALYs and willingness-to-pay threshold. A higher NMB indicates greater cost-effectiveness.
In women aged 65 to 80, population screening was slightly more cost-effective than universal supplementation, with an incremental NMB of $224 compared with $189 (P < .001). Population screening in men was also more cost-effective than universal supplementation (incremental NMB $298 vs $260, P < .001). Results differed according to age group. In those aged 65, population screening had cost-effectiveness similar to that of universal supplementation in women ($59 vs $71) and men ($114 vs $120), whereas in those aged 80, population screening was substantially more cost-effective than universal supplementation in women ($563 vs $428) and men ($703 vs $571).
Population screening and universal supplementation for vitamin D insufficiency are cost-effective strategies in community-dwelling older women and men. In the oldest old, population screening may be more cost-effective than universal supplementation.