Vitamin D deficiency: prevention or treatment?

Christos S Zipitis ^1*, Georgios A Markides ² and Ian L Swann ¹

¹ Burnley General Hospital, United Kingdom
² The University of Manchester, United Kingdom

^* To whom correspondence should be addressed. E-mail: czipitis{at}hotmail.com.

Accepted 29 June 2006

Abstract

Vitamin D deficiency is a chronic condition with well known consequences contributing to general ill health. There is a widespread belief that vitamin D deficiency is making a come-back in our catchment area since the cessation of funding of vitamin D supplementation by the Primary Care Trusts. This study aims to verify this and also to assess the cost effectiveness of reintroduction of vitamin D supplementation in our Trust, Burnley Health Care NHS Trust. Vitamin D deficient patients presenting between January 1994 and May 2005 were identified and data retrospectively collected from their case notes. The cost of treatment and theoretical cost of primary prevention for the Trust population were calculated using previous and current DoH guidelines. Overall fourteen cases were identified. 86% presented in the last 5 years. 93% of the affected patients were of Asian origin. The incidence of vitamin D deficiency for our population is 1 in 923 children overall and 1 in 117 in children of Asian origin. The average cost of treatment for each child presenting with Vitamin D deficiency is £2500 while the theoretical cost of prevention of a new case of vitamin D deficiency in the Asian population through primary prevention according to COMA guidance is £2400. In our Trust vitamin D deficiency is re-emerging. The overwhelming majority of our patients are of Asian origin. The cost of primary prevention for this high risk population compares favourably both medically and financially to treatment of established disease. We suggest that Primary Care Trusts provide funds for vitamin D supplementation of Asian children for at least the first 2 years of life.

Keywords: cost-benefit, hypocalcaemia, rickets, treatment, vitamin D deficiency

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