How Alberta Canada restricts Vitamin D testing

Created May 2016

LESS IS MORE, Testing Vitamin D Levels and Choosing Wisely

JAMA Internal Medicine - Research Letter | May 23, 2016

Robert Ferrari, MD, MSc (Med), FRCPC1,2; Connie Prosser, PhD, FCACB3

JAMA Intern Med. Published online May 23, 2016. doi:10.1001/jamainternmed.2016.1929

This is another example of a country trying to save money by restricting vitamin D testsAlberta is restricting tests to people who already have vitamin D deficiency diseases,AND only allowing a test once every 3 monthsSee also Vitamin D Life* Vitamin D test costs reimbursed in Japan – Aug 2016* France restricts payments for Vitamin D tests – Dec 2015* Vitamin D test costs Obamacare pregnant woman 214 dollars (vs 6 dollars for a bottle) – Oct 2015* Medicare now pays for just one vitamin D test , but 20 CT scans for smokers – Feb 2015* No vitamin D test needed before supplementing (typically) – April 2014* Low cost vitamin D Blood Tests * buy your own test if your govt does not pay for an expensive test* better still - just supplement with vitamin D

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The study by Rosenberg et al1 illustrates how difficult it may be to achieve substantial reductions in unnecessary testing despite extensive awareness and publication of recommendations from the Choosing Wisely campaign. It may be that, rather than education, physicians need implementation tools built into the system of ordering laboratory or radiologic tests. Examples of this can be a priori criteria introduced onto the laboratory requisition form for a given test (ie, minimal criteria must be met for the test to be ordered), frequency-based restrictions (eg, a test cannot be ordered more often than every 3 months, with the timing of the most recent test monitored by the laboratory), or simply placing the test on a separate ordering form so that it is not captured in a carte blanche approach to test ordering.

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Tags: Canada Tests