title: Cost-effectiveness and budget impact of Empirical vitamin D therapy on unintentional falls in older adults in the UK.
abstract: OBJECTIVE
  To evaluate the health outcomes and economics associated with the current guidance relating to the prevention of falls in the elderly through vitamin D supplementation.
  
  
  METHODS
  UK.
  
  
  METHODS
  UK population aged 60 years and above.
  
  
  METHODS
  A Markov health state transition model simulated patient transitions between key fall-related outcomes using a 5-year horizon and annual cycles to assess the costs and benefits of empirical treatment with colecalciferol 800 iu daily.
  
  
  METHODS
  Costs and health outcomes attributable to fall prevention following vitamin D supplementation.
  
  
  RESULTS
  Our model shows that treating the UK population aged 60 years and above with 800 iu colecalciferol would, over a 5-year period: (1) prevent in excess of 430,000 minor falls; (2) avoid 190,000 major falls; (3) prevent 1579 acute deaths; (4) avoid 84,000 person-years of long-term care and (5) prevent 8300 deaths associated with increased mortality in long-term care. The greatest gains are seen among those 75 years and older. Based on reduction in falls alone, the intervention in all adults aged 65+ is cost-saving and leads to increased quality adjusted life years. Treating all adults aged 60+ incurs an intervention cost of £2.70bn over 5 years, yet produces a -£3.12bn reduction in fall-related costs; a net saving of £420M. Increasing the lower bound age limit by 5-year increments increases budget impact to -£1.17bn, -£1.75bn, and -£2.06bn for adults 65+, 70+ and 75+, respectively.
  
  
  CONCLUSIONS
  This study shows that treatment of the elderly UK population with colecalciferol 800 iu daily would be associated with reductions in mortality and substantial cost-savings through fall prevention.
authors.affiliation: Cochrane Institute for Primary Care & Public Health, Cardiff University, Cardiff, UK.
authors.forename: C D
authors.initials: CD
authors.lastname: Poole
authors.affiliation: Torbay General Hospital, Torquay, Devon, UK.
authors.forename: J
authors.initials: J
authors.lastname: Smith
authors.affiliation: Centre for Diabetes and Endocrinology, University Hospital of Wales, Cardiff, UK.
authors.forename: J S
authors.initials: JS
authors.lastname: Davies
mesh_terms: D000058:Accidental Falls / Q000191:economics / Q000517:prevention & control*; D000368:Aged; D050071:Bone Density Conservation Agents / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D019587:Dietary Supplements; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000191:economics; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D013997:Time Factors; D006113:United Kingdom; D014807:Vitamin D / Q000191:economics / Q000627:therapeutic use*
chemical_list: D050071:Bone Density Conservation Agents; D014807:Vitamin D
keywords: GERIATRIC MEDICINE; HEALTH ECONOMICS