Comparison of Cost‐Effectiveness of Vitamin D Screening with That of Universal Supplementation in Preventing Falls in Community‐Dwelling Older Adults. Issue 5 (30th April 2013)

• Record Type: Journal Article
• Authors: Lee, Richard H.; Weber, Thomas; Colón‐Emeric, Cathleen
• Is Part Of: Journal of the American Geriatrics Society. Volume 61:Issue 5(2013:May)
• Page Start: 707
• Page End: 714
• Publication Date: 2013-04-30
• Subjects: Geriatrics -- Periodicals; 618.97
• DOI: 10.1111/jgs.12213
• Languages: English
• ISSNs: 0002-8614

Abstract

<abstract abstract-type="main" id="jgs12213-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jgs12213-sec-0001" sec-type="section"> <title>Objectives</title> <p>To compare the cost‐effectiveness of population screening for vitamin D insufficiency with that of universal vitamin D supplementation in community‐dwelling older adults.</p> </sec> <sec id="jgs12213-sec-0002" sec-type="section"> <title>Design</title> <p>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.</p> </sec> <sec id="jgs12213-sec-0003" sec-type="section"> <title>Setting</title> <p>Decision analysis simulation from a societal perspective.</p> </sec> <sec id="jgs12213-sec-0004" sec-type="section"> <title>Participants</title> <p>Hypothetical cohort of community‐dwelling women and men aged 65 to 80.</p> </sec> <sec id="jgs12213-sec-0005" sec-type="section"> <title>Measurements</title> <p>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.</p> </sec> <sec id="jgs12213-sec-0006" sec-type="section"> <title>Results</title> <p>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 (<italic>P </italic><<italic> </italic>.001). Population screening in men was also more cost‐effective than universal supplementation (incremental NMB $298 vs $260, <italic>P </italic><<italic> </italic>.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).</p> </sec> <sec id="jgs12213-sec-0007" sec-type="section"> <title>Conclusion</title> <p>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.</p> </sec> </abstract>