Vitamin D Prescription Changes Lead to Discontinuation Among Dutch Patients

Approximately 6.4 percent of individuals in the Netherlands who were prescribed high-strength vitamin D supplements stopped taking them after the termination of prescription reimbursement by the Minister of Health, Welfare and Sport in 2023, according to research led by Amit Singh, a pharmacist and PhD candidate at the Sint Maartenskliniek in Nijmegen, Marcia Vervloet, a senior researcher at Nivel, and their team.

Impact on Vulnerable Populations

Between one and one-and-a-half million people in the Netherlands receive vitamin D supplementation prescriptions from their healthcare providers, including general practitioners and medical specialists. These individuals often include the elderly, those with osteoporosis, or people with rheumatoid arthritis (RA) or other rheumatic conditions – all groups at risk for vitamin D deficiency. Vitamin D deficiency can reduce calcium absorption and increase the risk of osteoporosis [3].

Financial Barriers to Access

“People in a worse financial situation in particular have stopped taking vitamin D,” explains Amit Singh.

Prior to 2023, high-strength vitamin D supplements prescribed by a doctor were covered by basic health insurance. The removal of this reimbursement prompted the Dutch Healthcare Institute (ZIN) to investigate the potential consequences for vulnerable groups. This investigation, conducted by Nivel, Reade rehabilitation center, and the Sint Maartenskliniek, involved a study of 4,800 supplement users, primarily from these vulnerable populations.

Recent Policy Changes and Fortification Efforts

In 2023, the Minister of Health proposed allowing vitamin D fortification of yogurt and kefir and expanding eligibility for a dairy-related exemption from front-of-package nutrition labeling requirements [1], [2]. While this policy may reduce vitamin D inadequacies in those who do not take supplements, research suggests it won’t eliminate population-level deficiencies, and supplementation remains important [3].

Vitamin D and COVID-19

Research into the role of vitamin D in mitigating the impact of COVID-19 has also been conducted. Adess Singh presented data on vitamin D’s potential benefits to the Minister of Health for Punjab, India, though political factors hindered implementation [4].