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Cost-effectiveness of vitamin D3 supplementation in older adults with vitamin D deficiency in Ireland
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  • Published on:
    Cost-effectiveness of vitamin D3 supplementation in older adults with vitamin D deficiency in Ireland, by Lacey et al.
    • Federica Amati, Medical Scientist Imperial College London
    • Other Contributors:
      • Lucy J McCann, Medical Doctor
      • Tim D Spector, Professor of Genetic Epidemiology
      • Celine Tabche, Teaching Fellow

    Lacey et al. recommended that a vitamin D3 supplementation strategy be first considered in adults ≥70 years of age.1 Their analysis assessed the cost-effectiveness of a systematic public health programme in older adults, measuring serum 25(OH)D levels and treating and monitoring deficient adults with vitamin D3 supplements. We wish to highlight several omissions in the debate.
    Firstly, Lacey et al. worked under the assumption that vitamin D3 supplementation decreases the risk of excess morbidity and mortality, including those related to cancer and fractures. However, these ideas remain controversial within the literature. The Cochrane meta-analysis discussed by Lacey et al., in fact, concludes that the risks of biases, including attrition and reporting bias, have meant their findings among population groups remain inconclusive to recommend or refute vitamin D in the prevention of mortality or cancer-related mortality.2 A more recent meta-analysis by Zhang et al. (2019) found no association between supplementation and all-cause mortality.3 The discrepancy of findings amongst meta-analyses must be acknowledged when producing cost-effective analyses and recommendations such as this one.
    Notably, supplementation cannot be advocated without mentioning its dangers. The failure to consider evidence on the potential risks of vitamin D3 supplementation as shown in trials of high dose products increasing fractures (ref) and recently when Kassis et al. found more signif...

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    Conflict of Interest:
    None declared.