This study modelled the lifetime costs and benefits of daily vitamin D3 for US adults with prediabetes. It ran the CDC–RTI diabetes microsimulation on 10,000 simulated people built from 4176 NHANES 2013–2018 adults. It assumed 85% adherence and a 15% cut in diabetes risk, from pooled data of three placebo-controlled trials. Vitamin D cut lifetime costs by $3208 per person, though the 95% uncertainty interval included a $171 rise. It added 0.12 QALYs and a net monetary benefit of $15,483 at $100,000 per QALY. The main limitation is that lifetime gains are model extrapolations of the trial effect, without long-term trial follow-up.
Why it is interesting: Diabetes prevention trials mostly test lifestyle programmes or drugs that reach few people. The model finds that a $60-a-year supplement offsets its own cost through fewer complications, if the modest trial effect lasts.
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