Vitamin D supplementation to the older adult population in Germany has the cost‐saving potential of preventing almost 30 000 cancer deaths per year

Abstract

Recent meta-analyses of randomized controlled trials (RCTs) have demonstrated significant reduction in cancer mortality by vitamin D supplementation. We estimated costs and savings for preventing cancer deaths by vitamin D supplementation of the population aged 50+ years in Germany. Our analysis is based on national data on cancer mortality in 2016. The number of preventable cancer deaths was estimated by multiplying cancer deaths above age 50 with the estimated proportionate reduction in cancer mortality derived by vitamin D supplementation according to meta-analyses of RCTs (13%). Saved costs were estimated by multiplying this number by estimated end-of-life cancer care costs (€40 000). Annual costs of vitamin D supplementation were estimated at 25€ per person above age 50. Comprehensive sensitivity analyses were conducted. In the main analysis, vitamin D supplementation was estimated to prevent almost 30 000 cancer deaths per year at approximate costs of €900 million and savings of €1.154 billion, suggesting net savings of €254 million. Our results support promotion of supplementation of vitamin D among older adults as a costsaving approach to substantially reduce cancer mortality.

Potential of Vitamin D Food Fortification in Prevention of Cancer Deaths—A Modeling Study

“…Of note, expected savings are entirely attributable to reductions in cancer mortality and not in cancer incidence, which is not affected by vitamin D. End-stage treatment costs among patients dying from cancer are, however, more than four-fold higher than among deaths from other causes [42], implying large savings even in the absence of a reduction in cancer incidence. Regarding achievable cancer mortality reduction, fortification is thus expected to be even considerably more economic than daily supplementation with vitamin D [3], with expected effects being only slightly smaller despite estimated costs being dramatically lower. A further advantage of food fortification is that it would not require regular medication intake and would also reach subgroups of the population who may be at particularly high risk of vitamin D deficiency and less likely to take vitamin D supplements.…”

“…Total saved cancer treatment costs were calculated by multiplying numbers of preventable cancer deaths with estimated average end-of-life cancer care costs. The latter have been estimated to be around 40,000€ per cancer death, as outlined in our previous study on vitamin D supplementation [3]. It should be noted that neither our previous study nor the current study aimed for a comprehensive, precise cost-effectiveness analysis or cost-savings analysis, which in our view, would not be justified given the uncertainties, variations across countries, and dynamics in several of the key factors involved (including end-of-life cancer care costs).…”

“…Recent meta-analyses of randomized clinical trials have consistently suggested a reduction of cancer mortality by approximately 13% through vitamin D supplementation [1,2]. We previously demonstrated, using cancer registry data from Germany, that vitamin D supplementation could be a very cost-effective if not cost-saving approach to reduce the burden of cancer deaths [3]. Another potentially even more cost-saving approach could be food fortification by vitamin D, a policy that has been implemented in a few countries, mainly for purposes other than prevention of cancer mortality [4][5][6][7][8].…”

“…We focused on savings from prevented cancer deaths and disregarded the positive impact of vitamin D on various other health outcomes, such as osteoporosis (fracture costs). In addition to preventable cancer deaths, we calculated life-years saved as preventable years of life lost (preventable YLL) and monetary savings from prevented cancer deaths as described previously elsewhere [3]. In brief, YLL were calculated as the number of cancer deaths at each age group in 2016 multiplied by further life expectancy at the midpoint of each age interval and summed across sexes and 5-year age groups.…”

Preliminary cost-effectiveness of vitamin D3 supplementation in older adults with vitamin D deficiency (defined by serum 25-hydroxyvitamin D) in Ireland

“…The methodology (3) uses Irish Life Table No. 17 (from Central Statistics Office (CSO)), together with invasive cancer deaths in 2015 from the National Cancer Registry of Ireland (NCRI), and the number of bone fractures in Ireland (2014) and associated hospitalisation costs (4) . Three age groups were investigated: (1) ≥50 years, (2) ≥60 years, (3) ≥70 years.…”