French law: what about a reasoned reimbursement of serum vitamin D assays?

Souberbielle, Jean‐Claude; Benhamou, Claude Laurent; Cortet, Bernard; Rousière, Mickaël; Roux, Christian; Abitbol, V.; Annweiler, Cédric; Audran, Maurice; Bacchetta, Justine; Bataille, Pierre; Beauchet, Olivier; Bardet, Rémi; Benachi, Alexandra; Bérenbaum, Francis; Blain, Hubert; Borson‐Chazot, Françoise; Breuil, Véronique; Briot, Karine; Brunet, Philippe; Carel, Jean‐Claude; Caron, Philippe; Chabre, Olivier; Chanson, Philippe; Chapurlat, Roland; Cochat, Pierre; Coutant, Régis; Christin-Maître, Sophie; Cohen‐Solal, Martine; Combe, Christian; Cormier, Catherine; Courbebaisse, Marie; Debrus, Grégory; Delemer, Brigitte; Deschênes, Georges; Duquenne, M.; Duval, Guillaume; Fardellone, Patrice; Fouque, Denis; Friedlander, Gérard; Gauvain, Jean-Bernard; Groussin, Lionel; Guggenbuhl, Pascal; Houillier, Pascal; Hannedouche, Thierry; Jacot, William; Javier, Rose‐Marie; Gadrey, Jean; Jeandel, Claude; Joly, Dominique; Kamenický, Peter; Lafage-Proust, Marie-Hélène; Lebouc, Yves; Legrand, Érick; Lévy-Weil, Florence; Linglart, Agnès; Machet, L.; Maheu, E.; Mallet, E.; Marcelli, Christian; Marès, P.; Mariat, Christophe; Maruani, Gérard; Maugars, Yves; Montagnon, France; Moulin, Anne‐Marie; Orcel, Philippe; Personne, Virginie; Pierrot‐Deseilligny, Charles; Polak, M.; Pouteil‐Noble, Claire; Prié, Dominique; Raynaud-Simon, A.; Rolland, Y.; Sadoul, Jean‐Louis; Sault, Corinne; Schott, Anne-Marie; Sermet‐Gaudelus, Isabelle; Soubrier, Martin; Tack, Ivan; Thervet, Éric; Tostivint, Isabelle; Touraine, Philippe; Trémollières, Florence; Ureña-Torres, Pablo; Viard, Jean‐Paul; Wémeau, Jean-Louis; Weryha, G.; Winer, Norbert; Young, Jacques; Thomas, Thierry

doi:10.1684/pnv.2016.0631

Cited by 7 publications

(6 citation statements)

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“…An additional 34 articles were excluded after title and abstract review because clinicians, patients, the setting, or outcomes did not meet the inclusion criteria. The remaining 38 articles were included in this review [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ]. Two gray literature documents were included within the final 38 articles.…”

Section: Resultsmentioning

confidence: 99%

“…Interventions aimed at reducing inappropriate vitamin D test-ordering have been impactful. For example, the national health systems in France and Ontario, Canada restricted testing to only a subset of high-risk conditions [ 63 , 64 ]. Through reimbursing 25-OH-D testing only for osteoporosis/osteopenia, rickets, malabsorption syndromes, renal disease, and concurrent medications which may affect vitamin D metabolism, officials in Ontario predict a savings of approximately $65 million annually [ 64 ].…”

Section: Resultsmentioning

confidence: 99%

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Clinical Management of Low Vitamin D: A Scoping Review of Physicians’ Practices

et al. 2018

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The role of vitamin D in the prevention and treatment of non-skeletal health issues has received significant media and research attention in recent years. Costs associated with clinical management of low vitamin D (LVD) have increased exponentially. However, no clear evidence supports vitamin D screening to improve health outcomes. Authoritative bodies and professional societies do not recommend population-wide vitamin D screening in community-dwelling adults who are asymptomatic or at low risk of LVD. To assess patterns of physicians’ management of LVD in this conflicting environment, we conducted a scoping review of three electronic databases and the gray literature. Thirty-eight records met inclusion criteria and were summarized in an evidence table. Thirteen studies published between 2006 and 2015 across seven countries showed a consistent increase in vitamin D lab tests and related costs. Many vitamin D testing patterns reflected screening rather than targeted testing for individuals at high risk of vitamin D deficiency or insufficiency. Interventions aimed at managing inappropriate clinical practices related to LVD were effective in the short term. Variability and controversy were pervasive in many aspects of vitamin D management, shining a light on physicians’ practices in the face of uncertainty. Future research is needed to inform better clinical guidelines and to assess implementation practices that encourage evidence-based management of LVD in adult populations.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Clinical Management of Low Vitamin D: A Scoping Review of Physicians’ Practices

et al. 2018

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“…In the UK, a 17-fold increase in vitamin D testing and prescription costs, from £1,647 in 2008 to £28,913 in 2014 per 100,000 patient-years has been reported ( 10 ), perhaps increased testing leads a dramatic increase in the diagnosis of vitamin D deficiency as well. The overvaluing of 25-OHD measurements without accompanying ALP or PTH measurements ( 11 ) and diagnosing ‘vitamin D deficiency’ based on diverse thresholds have resulted in an increased use of high-dose vitamin D ( 12 ). However, the Institute of Medicine has emphasized that studies concerning vitamin D and extra-skeletal problems, such as cancer, cardiovascular diseases, diabetes and autoimmune diseases, do not provide consistent evidence and that there is no need to determine varying vitamin D thresholds for these diseases, and thus to prescribe more vitamin D ( 7 , 8 , 13 ).…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Status Across Age Groups in Turkey: Results of 108,742 Samples from a Single Laboratory

Mutlu¹,

Aksu²,

Bereket³

et al. 2020

Jcrpe

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Objective: The aim was to determine vitamin D status in the general population in Turkey between 2011 and 2016, and to evaluate the effectiveness of the national vitamin D supplementation programme. Methods: Serum 25-hydroxyvitamin D (25-OHD) measurement data were retrieved from an internationally accredited laboratory, operating nationwide. A total of 108,742 measurements of 25-OHD were analyzed using the cut-off values of 0-11 ng/mL, 12-19 ng/mL, 20-49 ng/mL, 50-70 ng/mL and >70 ng/mL for vitamin D deficiency, insufficiency, sufficiency, possibly harmful and excess respectively. Results: The mean±standard deviation 25-OHD level was 21.6±13.3 ng/mL. Mean 25-OHD concentrations by age groups were: 37.3 ng/mL, 30.1 ng/mL and 23.7 ng/mL for <1, 1-10 and 11-18 year old groups, respectively. Mean 25-OHD levels of children <1 year and 1-3 years of age were significantly higher than those found in other age groups. The prevalence of vitamin D deficiency (<12 ng/mL) was lowest in children at 1-3 years of age (5%). In subjects older than 18 years of age, mean 25-OHD levels were 18.2 ng/mL, 20.1 ng/mL, 21.9 ng/mL and 21.1 ng/mL for age groups 19-30, 31-50, 51-70 and >70 years, respectively. Conclusion: Successful implementation of the national vitamin D supplementation programme, appears to have nearly eliminated vitamin D deficiency for children under 1-years of age. However, the positive impact of the vitamin D supplementation diminishes as children get older suggesting that supplementation may be required in the older children and adults. In addition, improved awareness of the benefits and risks of excess vitamin D should prevent unnecessary and excessive use of vitamin D supplements.

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“…For example, in France, the indications for serum vitamin D level measurement were restricted only to rickets, osteomalacia, elderly with a high risk of fractures, kidney transplant recipients, and adults after bariatric surgery. According to Souberbielle et al (2016), such indications were too strict. A group of French clinicians proposed a different approach where bone fragility, chronic renal failure, malabsorption, and other clinical signs suggesting vitamin D deficiency or vitamin D toxicity should also be taken into consideration for vitamin D measurements [60].…”

Section: Vitamin D Deficiency-epidemiology and Current Measurement Inmentioning

confidence: 99%

The Significance of Measuring Vitamin D Serum Levels in Women with Uterine Fibroids

et al. 2020

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Uterine fibroids (UFs) are benign tumors originating from smooth muscle cells and are considered a common pathology that affects numerous women which is a notable socio-economic problem. Several UF risk factors have been identified including black race, obesity, and vitamin D deficiency. Vitamin D is steroid compound with pleiotropic effects on the human body. Vitamin D deficiency is a major public health concern worldwide. Several studies have shown that the majority of UF patients experienced hypovitaminosis D. In addition, sufficient vitamin D serum levels are associated with the reduced risk of UFs. In this review, we present available data highlighting the importance of measuring vitamin D serum levels in women with UFs and women at a high risk for UF development. We proposed a preliminary clinical instruction of 25-hydroxyvitamin D measurements and vitamin D supplementation for clinicians who are involved in the treatment of patients with UFs. Achieving sufficient serum levels of vitamin D might be of interest in patients with UFs. Screening, supplementation, treatment guidelines, and public health strategies for vitamin D deficiency in women with UFs as well as women at a high risk of UF development might be of potential importance as well.

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French law: what about a reasoned reimbursement of serum vitamin D assays?

Cited by 7 publications

References 0 publications

Clinical Management of Low Vitamin D: A Scoping Review of Physicians’ Practices

Clinical Management of Low Vitamin D: A Scoping Review of Physicians’ Practices

Vitamin D Status Across Age Groups in Turkey: Results of 108,742 Samples from a Single Laboratory

The Significance of Measuring Vitamin D Serum Levels in Women with Uterine Fibroids

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