Authors' objectives: In Switzerland, the utilization of vitamin D tests has increased over 100-fold since 2006, leading to substantial increases in costs. Although vitamin D supplementation is recommended in clinical practice, the benefits of vitamin D testing prior to vitamin D supplementation remain unknown.

Authors' results and conclusions: In regards to vitamin D testing for the defined at-risk groups (persons with bone disorders, older adults, obese individuals, pregnant women, people with dark skin, and athletes), no primary studies were identified which assess health outcomes. Economic results for testing in older adults were mixed and non-conclusive. In one study, it was estimated that for older people as well as for people with darker skin, overall costs are lower if supplementation of vitamin D without prior vitamin D testing is given instead of implementing a vit-amin D testing and treatment strategy. In regards to vitamin D supplementation, we pursued a systematic but non-comprehensive approach to the literature search and selection, which carries a potential risk of bias. On this basis, the evi-dence on effectiveness of vitamin D supplementation was generally mixed and not conclusive. Based on the scoping report the feasibility to produce a full HTA has been considered. A full HTA would not be justified at present due to the absence of clinical studies evaluating vitamin D testing. Only after such studies have become available could the topic be re-considered. Vitamin D testing is recommended for patients where it is medically necessary, and this is not disputed in the present report. The lack of available evidence for vitamin D testing for defined at-risk groups from our review, could be informative in guiding a decision policy on vitamin D testing.

Authors' methods: We conducted a systematic literature search to identify the clinical and economic evidence related to testing for vitamin D for at-risk groups defined by the Swiss Federal Commission of Nutrition (FCN). We further examined the literature regarding the clinical effect of vitamin D supplementation in the same at-risk groups. If no benefit from supplementation can be shown, then benefits of testing can be ruled out, if these tests aim to inform the decision to supplement.

Project Status: Completed

URL for project: https://www.bag.admin.ch/bag/en/home/versicherungen/krankenversicherung/krankenversicherung-leistungen-tarife/hta/hta-projekte/vitamindtests.html

Year Published: 2020

URL for published report: https://www.bag.admin.ch/dam/bag/en/dokumente/kuv-leistungen/leistungen-und-tarife/hta/berichte/h0029vitd-scoping-report.pdf.download.pdf/h0029vitd-scoping-report.pdf

URL for additional information: https://www.bag.admin.ch/bag/en/home/versicherungen/krankenversicherung/krankenversicherung-leistungen-tarife/hta/hta-programm.html

English language abstract: An English language summary is available

Publication Type: Other

Country: Switzerland

Organisation Name: Swiss Federal Office of Public Health (FOPH)

Contact Address: Federal Office of Public Health, Schwarzenburgstrasse 157, CH-3003 Berne, Switzerland

Contact Name: Stephanie Vollenweider

Contact Email: hta@bag.admin.ch

Copyright: Swiss Federal Office of Public Health