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August 13, 2010 11:00 AM

Ontario is listening to expert medical advice and proposing to curb unnecessary Vitamin D testing for otherwise healthy people.

In June, Ontario's Health Technology Advisory Committee concluded that the routine use of Vitamin D testing for the general population could not be justified based on current evidence. This builds on other recent medical expert evidence that recommended changes to sleep studies, bone mineral density and pre-operative testing for cataract surgery.

Since 2004, Vitamin D testing has grown by 2,500 per cent - jumping from 29,000 tests to over 700,000 in 2009. Moving toward evidence based testing supports Ontario's Excellent Care for All agenda to ensure health care investments are getting results and improving patient care. The proposed change to Vitamin D testing would result in resources being redirected to other laboratory services.

The province would continue to cover Vitamin D testing for patients where medical evidence indicates there is a need. Ontario would continue to fund tests for patients with medical conditions such as Osteoporosis, Rickets, Osteopenia, Malabsorption Syndromes and Renal Disease. Ontarians who are on medications that affect Vitamin D metabolism would also still be covered.

The public is invited to comment on the proposed change to Vitamin D testing which will be posted on Ontario's regulatory registry until September 26.

In June, Ontario passed the Excellent Care for All Act, which lays the foundation for these improvements and is part of the Open Ontario Plan to improve the quality and value of health care.


QUICK FACTS

*This year it is expected that the government will be billed up to $66 million on Vitamin D tests compared to $1.7 million in 2004.
*If current trends continue, billings could reach up to $155 million by 2011/12.
*Manitoba, Nova Scotia, Newfoundland, Prince Edward Island, Labrador and Saskatchewan have all moved to limit unnecessary Vitamin D testing.

Michael Holick, a recognized expert on the topic, has stated “with the recognition of wide spread deficiency/insufficiency in children and adults there is no need to measure everybody’s blood 25 hydroxy vitamin D”.

...OHTAC did recommend that measurement of serum 25-hydroxy vitamin D may be of clinical value in individuals with conditions in which vitamin D is implicated such as:
* Significant renal or liver disease
* Osteomalacia, osteopenia or osteoporosis
* Possible cases of rickets
* Malabsorption syndromes
* Hypo or hypercalcemia/hyperphosphatemia
* Hypo or hyperparathyroidism.11