Vitamin D Testing Protocol Effective Date: October 1, 2010 For full protocol please go to website

This protocol covers the appropriate use of vitamin D testing for the general adult population (? 19 years) in BC. It excludes patients with malabsorption syndromes, renal failure, unexplained bone pain, unusual fractures, and other evidence of metabolic bone disorders.

1A. LABORATORY TESTING

• Routine serum vitamin D testing or screening for vitamin D deficiency is not recommended.
• Routine serum vitamin D testing during vitamin D supplementation is not recommended.
• The optimum level of serum vitamin D, if one exists, has not been determined.
• Most BC residents are at risk of low vitamin D levels in the fall, winter and spring.
• Supplementing with vitamin D is safe and therefore supplementation is generally recommended.
• An exception to “no testing” includes some patients with advanced renal failure, mineral and/or bone disease.
• Specialist consultation is recommended for patients with malabsorption, unexplained bone pain, and unusual fractures, or suspicion of metabolic bone disorder.

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They are only concerned about stopping new costs, not reducing total cost of medical care

Clip from their press release.

Over the last five years, vitamin D tests have increased ten-fold in B.C.
In 2008/09, there were 22,748 vitamin D laboratory tests billed to MSP by B.C. physicians representing a cost of over $2 million.
To address this, representatives from the ministry and the BC Medical Association developed the new protocol that also reduced the laboratory MSP fee for vitamin D tests (from $93.63 to $61.50 per test).
It is anticipated that physicians who follow the protocol will prescribe the test less frequently.
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The above, from British Columbia, Canada, is just the first portion of a 2 page PDF summary

Summary and full version are both attached to this VitaminDWiki page

see also Ontario and other Canadian provinces

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A solution which reduces govt costs for testing AND improves health

• BC could setup an additional system for testing for vitamin D at home, where each person would pay for his own test
• The individual would order and pay, perhaps $40 for the kit to be mailed to them CLICK HERE for Example tests
• The people would receive the test kit in the mail, send it back, and get the results via e-mail
• The lower cost ($40 to individual instead of $62 to government)
  • would result from volume purchase and cutting out the costs for physician, billing, nurse drawing the blood, etc.
• Each individual could order as many or as few tests as he wants - at no cost to the government at all.

Problem encountered with this solution

Contacted a low cost US based testing group. Found that they are restricted from selling their vitamin D testing kits to Canada
Unclear if the restriction is by the US or Canada