Rickets: Less costly to prevent than to treat SE Asians in UK – 2006

Vitamin D deficiency: prevention or treatment?

Arch Dis Child. 2006 Dec;91(12):1011-4. Epub 2006 Aug 31.
Zipitis CS czipitis at hotmail.com , Markides GA, Swann IL.
Burnley General Hospital, Casterton Avenue, Burnley, Lancashire, BB10 2PQ, UK.

BACKGROUND: Vitamin D deficiency is a chronic condition which contributes to general ill health and seems to be re-emerging in our catchment area since funding of vitamin D supplementation by Primary Care Trusts ceased. This study aims to verify this situation and to assess the cost effectiveness of reintroducing vitamin D supplementation in the Burnley Health Care NHS Trust.

METHODS: 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 the theoretical cost of primary prevention for the Trust population were calculated using previous and current DoH guidelines.

RESULTS: Fourteen patients were identified, of whom 86% presented in the last 5 years and 93% 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 such child is pound 2500, while the theoretical cost of prevention of vitamin D deficiency in the Asian population through primary prevention according to COMA guidance is pound2400 per case.

CONCLUSIONS: Vitamin D deficiency is re-emerging in our Trust.
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 with 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.

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