Pharmacoeconomic profile of vitamin D3: in the prevention of osteoporosis

Abstract

Hypovitaminosis D is one of the principal risk factors for osteoporosis. Some studies estimated that more of 40% of Italian women over sixty are osteoporotic. Osteoporotic fracture is a significant cause of morbidity and cost. In Italy, in 2002, the global burden for hip fractures in over 65-years old patients has been estimated in more than one billion euro. Administration of vitamin D to prevent pathological fractures has a low cost-efficacy ratio, which reaches dominance compared to non-treatment in women over 70, i.e. avoided management costs of fractures exceed cost of therapy. In primary prevention, use of vitamin D3 involves some advantages with respect to partially or totally activated forms: higher safety and tolerability, lower costs and less frequent administrations. In order to prevent hypovitaminosis D, Regional Health Service of Toscana started to dispense free cholecalciferol to every person with more than 65 years (two 300.000 UI vials). The impact on the National Health Service budget, supposing all Italians over 65 would take cholecalciferol, has been estimated; annual savings resulted in more than 100.000.000 euro, only for hospitalization costs due to avoided fractures.