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The cost of vitamin D blood tests

Posted on: March 10, 2012   by  John Cannell, MD


How much more does it cost the medical system to have doctors order vitamin D blood tests? Already, both Canada and Medicare have limited doctor’s ability to test for vitamin D deficiency because the tests cost too much. How much do they cost in the picture of total health care costs?

The stunning answer from Dr. Beth Baily and colleagues at East Tennessee State University is that frequent vitamin D blood tests mean lower, not higher, total medical care costs. That’s right, ordering more vitamin D tests means lower total health care costs.

Bailey, Beth  et al.  Vitamin D Testing Patterns Among Six Veterans Medical Centers in the Southeastern United States: Links With Medical Costs.  Military Medicine, Volume 177, Number 1, January 2012 , pp. 70-76(7)

The researchers looked at the medical records of about 400,000 veterans from six VA medical centers in the Southeastern United States to find about 15,000 veterans who had a vitamin D level checked. Then they added up the total number of subsequent visits (inpatient and outpatient) and the total subsequent health care cost for each veteran, vitamin D tested or not.

As expected, outpatient costs were a little higher for veterans who had vitamin D testing. Then came the real shocker: average inpatient costs per patient were from 50% to 56% lower for veterans who had two follow-up vitamin D tests compared to no follow up test. The study also showed that the veterans who have been tested and effectively treated for their vitamin D deficiency have the lowest yearly inpatient costs, while the sites that have done the least testing had inpatient costs nearly triple that. While the authors were quick to point out vitamin D did not explain all of this huge difference, it clearly seemed to explain at least some of it and leaves one with the tragic reality that some of our veterans are dying needlessly.

I was so glad to see that the authors write, “The (local) VAMC has made a concerted effort to educate local health care providers regarding vitamin D deficiency over the past few years.” They went on the say, “Immediate implementation of this recommendation is highly desirable.” I agree. This is a public health problem that needs to be immediately treated with public health measures, including better sun exposure guidelines, supplementation guidelines, and food fortification.

Hats off to Drs. Beth Bailey, Todd Manning, and Alan Peiris, and my apologies to the others in the Tennessee VA system that I missed. They have discovered reduced total health care costs in veterans are associated with more vitamin D testing and less expensive subsequent hospital stays. They are government servants of the highest order. Therefore, it appears that Medicare has cut off its nose to spite its face, limiting vitamin D blood tests to save a little money, thus assuring that total costs of treating the elderly will be substantially higher. Now, how can we get this information to President Obama?

EDITED 3/24/12 by Brant Cebulla

8 Responses to The cost of vitamin D blood tests

  1. [email protected]

    Costs of vitamin D tests are also dropping.
    Latest, mailed from from UK. is $30
    Amount of testing is expected to increase 30% every year and is
    predicted to cost only $20 in a few years

  2. [email protected]

    Dear Doctor Cannell, I am a regular user of Vit D3, thanks to you and Dr. Joseph Mercola’s information. I take 5000 iu/day, occasionally double. I am 79 and generally in good health. I read almost all your reviews of research studies. Very good, easy (mostly) to understand and useful.
    I have have asked myself “How can I promote the diffusion of Vit D3 in the general public.?… I think that education is the starting point. My strategy would be to start some kind of popular information centre specifically about Vit D3, with discussion groups, (no matter how small the group may be). Distribute simply written literature based on your articles/review. This literature could become the textbook or guides for the discussion.
    What do you think? Is this a doable idea or just a dream? Do you have any suggestion?
    How could you interact with this initiative?
    Hoping to hear from you, I thank you
    Joseph Carraro, member of your Vitamin Council
    Toronto, Canada

  3. Dan

    Economies of scale should reduce the 25(OH)D test price as more person take the test regularly (twice per year). Chip-based testing arrays should make it very cheap to run blood tests.

  4. JohnWVaughan

    Dr Cannell: I am a Member of The Life Extenssion Foundation. They have a contract with a national labrotaory I think Labcorp. it is $47… I don’t know what Medicare ior the VA is being charged , but I suspect it is a ripoff in the order of $200… I think it would be helpful if you researched that cost from various sources and published the discrepancy that I suspect… Dr David Williams publicized you as a source to ZRT labs home est kit for $65. Thos e costs, in view of the benefits CAN NOT be a justification for refusing to test. I propose that you promote a two test package with ZRT. You need two tests. Where you are and then have you gotten there yet. Blessings onBeth Bailey for doing this valuable research. JOHN VAUGHAN

  5. JohnWVaughan

    Dr Cannell: On another subjecy… Improved clarity of the Vitamin C message. It seems that the E publications of the Council have fallen victim to the graphic artists. Your Print out of “Cost of Vitamin D Test” alongside of the latest publication from the Alzheimers association is startling. Both from the same Brother Printer. All of their copy, heads and body are crisp black. Your Headline is large and strong, So is “about John Cannell MD. and even the tiny blog signature BUT then body copy throughout the piece , even though it is the exact same font size of Ariel as in the Alzheimer’s piece, is a wishy washy grey. Hard to read. Since I’m paying for the ink why should your “ARTISTS” compromise communication Ask them to use the bold version of the same font size . and listen for the “Thank Yous” from your subscribers. John Vaughan

  6. Brant Cebulla

    A reader kindly pointed out that a 70 to 300% reduction in cost is not possible, as a 100% reduction in cost would be $0.

    Dr. Cannell and I took a look at the study again and believe that figure 8 is best to reference and use to correct this misprint. Average inpatient costs per patient show a 50-56% reduction in costs if the patient received 2 follow up vitamin D tests. Impressively, the reduction in costs was slightly less with only one follow up vitamin D test.

  7. Brant Cebulla

    I think that’s a great idea and right in line with what we’re planning on doing. Being able to afford the costs of print publication is another thing, however, and we may need to sell these kinds of publications at a small price. I do think this is feasible for the Council within a year or two, thanks to the support of members like yourself!
    Brant Cebulla

  8. Brant Cebulla

    Here is the link to the ZRT test: http://www.zrtlab.com/vitamindcouncil/

    There are a few options for in-home testing or even ordering a lab order online these days (see Henry’s link) but we still like the ZRT option; we know it’s accurate and it’s easy. Plus, a portion (15%) of the proceeds for each order go to the Council!

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