Rita

 

More to the point, what do the results show?  Are Australians VitD deficient as well as little Englanders?

 

If not, why is it being measured so much?  If they are, have we got the reference range wrong?

 

Michael

 

 

 

From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Rita Horvath
Sent: 09 October 2013 00:52
To: [log in to unmask]
Subject: Re: vitamin D measurements

 

Very similar data here in sunny (but very “sunscreened”) Australia too, with (on average) every 7th Australian having had a vit D test  in 2012. On average this meant 5.5 AUD spent on vit D testing for every single citizen in Australia in 2012. However, the government is reviewing the reimbursement schedule and the below data come from their review protocol.

(NB: France and the UK have about 3x as much population as Australia, so the figure from France indicates that the situation is still somewhat better in France than in AU – mind you the French may not use as much sunscreen as the Aussies; and the Brits perhaps still do not get enough sunshine, in spite of the global warming trends and increasing hot summers in the UK? J Time for action indeed!

 

Table A.2: Number of claims for Vitamin D testing MBS items since 2000/2001

MBS item no

Financial year

02/03

03/04

04/05

05/06

06/07

07/08

08/09

09/10

10/11

11/12

66608

73,330

117,474

171,288

249,933

445,854

847,029

1,492,904

2,219,553

2,982,658

3,481,966

66609

 

 

 

 

743

13,329

9,442

11,397

15,414

7,203

Total

73,330

117,474

171,288

249,933

446,597

860,358

1,502,346

2,230,950

2,998,072

3,489,169

Source: Department of Human Services Medicare

the number of claims for vitamin D testing is particularly significant for females aged between 24 and 84, showing a marked increase from 2008 to 2012 (green line) compared to 2004-2008 (red line) and 2000 to 2004 (blue line).

 

Figure A.1: Usage of MBS item 66608 by age and gender since 2000

The graph shows the breakdown by 4 year periods (for 2000 to 2014) and age group for males. For the 2000 to 2004 period the number of claims for Vitamin D testing was low over all age groups. 

Between 2004 and 2008  the ammount of claims remains low for all age groups with a small increase for age groups from 35 to 44 and 75 to 85 where claims are approximately 90,000.

Between 2008 and 2012 the number of claims is significantly higher with the number raising quickly from approximately 75,000 for 5 to 14 year olds to over 60,000 for 55 to 64 year olds at which point the number of claims drops of to approximately 575,000 for 65 to 74 year old, 40,000 for 75 to 84 year olds and finally approximately 100,000 for those over 85 years.This graph shows the number of MBS claims for vitamin D for women by the age group and date range.

Between 2000 and 2004 the number of claims were at their lowest with all age groups having less that 75,000 claims and the majority of claims falling between the age of 35 and 85.

Between 2004 and 2008 there were more claims. with 15 to 24 year olds claiming approximately 50,000 tests, 25 to 44 year olds claiming aproximately 125,000. There was a jump in the number for those between 45 to 74 with 45 to 45 year olds claiming over 200,000 tests, 55 to 64 year olds claiming around 220,000 and 65-74 year olds claiming around 200.000. The number of claims drops off here again with 75 to 84 year olds claiming just under 200,000 and those over 85 claiming less than 100,000.

Between 2008 and 2012 claims for those under 14 were still low. After this point there is a massive increase in the number of claims with the age group between 15 and 24 claiming almost 400,000, those between 25 and 34 as well as those between 35 and 44 claiming well in excess of 900,000. The number increasing a lot after this too with 45 and 54 claiming up to 1,200,000 and 55 to 64 year olds claiming almost 1,400,000. The number of claims drops a bit here with a steady decrease after the age of 65 to around 300,000 for those over 85.

 

 

Figure A.2 shows that the annual MBS benefits paid for vitamin D testing (item numbers 66608 and 66609) has increased significantly from $2.6 million in 2002 to $126.5 million in 2012.  The significant increase in the benefits paid for both item numbers is consistent with the increase in the volume of claims.

 

Figure A.2: Benefits paid for MBS item number 66608 and 66609 since 2002/2003

Source: Department of Human Services Medicare

 

 

Kind regards, Rita

Prof. Andrea Rita Horvath, MD, PhD, EurClinChem, FRCPath, FRCPA
Past President of the European Federation of Clinical Chemistry and Laboratory Medicine
Clinical Director, SEALS North, Department of Clinical Chemistry
Level 4, Campus Centre, Prince of Wales Hospital
Barker Street, Randwick, NSW 2031, Sydney, Australia
Tel: (+612)-9382 9078
Fax: (+612)-9382 9099
Mobile No: (+61)-404 027 843

 

From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Joseph WATINE
Sent: Sunday, 6 October 2013 8:05 PM
To: [log in to unmask]
Subject: vitamin D measurements

 

In France vitamine D measurement in blood is now the 5th lab test in terms of costs for the "sécurité sociale": it costed almost 100.000.000 Euros in 2111, and the number of requests of vitamin D are increasing exponentially: the costs were below 40.000 Euros in 2009. At such a speed of increase, it would not be surprising that the costs would reach 150.000.000 Euros in 2013 and thus vitamin D would become  the 2nd most costly test for the collectivity in France just after blood cell counts which cost 300.000.000 Euros each year (quite stable).

I would be interested to know whether or not such a waste of collective ressources are specific to France or if the same happens elsewhere in the world, particularly in the UK.

Best regards, Joseph, Villefranche-de-Rouergue, France

 

Dr Joseph Watine, PH, AIHP, PharmD, AAHU, EurClinChem 

Laboratoire de Biologie Polyvalente
Centre Hospitalier La Chartreuse
Avenue Caylet
12200 Villefranche-de-Rouergue
France

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