The cost-effectiveness of vitamin D supplementation for the prevention of type 2 diabetes in the United States: a microsimulation modelling study
- 1Converge: Centre for Chronic Disease and Population Health Research, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- 2Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Tufts Medical Center, Boston, MA 02111, USA
- 3Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
Abstract
Background: Vitamin D lowers the risk of type 2 diabetes in adults with prediabetes. We assessed the long-term cost-effectiveness of vitamin D supplementation for preventing type 2 diabetes.
Methods: We applied a validated microsimulation model to estimate long-term health and economic consequences of vitamin D in a representative cohort of 10,000 U.S. adults with prediabetes in the National Health and Nutrition Examination Survey (NHANES) 2013–2018 cohort. Treatment effects came from individual-participant data of three randomised trials of vitamin D versus placebo (D2d, USA, 2013–2018; DPVD, Japan, 2013–2019; Tromsø, Norway, 2008–2015; pooled analysis 2023). Cost-effectiveness was measured by an incremental cost-effectiveness ratio (ICER) in terms of cost per quality-adjusted life year (QALY) compared to no vitamin D. We conducted subgroup analyses by age, baseline fasting glucose level, body weight, and family history of diabetes. We performed one-way and probabilistic sensitivity analysis. Costs were in 2024 U.S. dollars. 10-year and lifetime time horizons were studied from a U.S. health care system perspective.
Findings: In a NHANES-derived cohort of 4176 adults with prediabetes (mean age 53.3 years [SD 17.0]; 2024 [49%] female; 2603 [62%] non-Hispanic White, 488 [12%] non-Hispanic Black, 668 [16%] Hispanic, 417 [10%] other race/ethnicity), vitamin D supplementation reduced per-person lifetime costs by $3208 (95% uncertainty interval [UI] −$5974 to $171), increased lifetime QALYs by 0.12 (95% UI 0.05–0.19), and yielded a lifetime net monetary benefit of $15,483 (95% UI 8108–21,907) at a willingness-to-pay threshold of $100,000/QALY. Life-years gained were 0.27 per person (95% UI 0.06–0.50). Vitamin D reduced the lifetime cumulative incidence of diabetes by 8% (95% UI 6.4–10.6%). Diabetes complications were reduced by an average of 6.4% (95% UI 3.2–8.7%). There were little differences in ICERs across subgroups. Changes in intervention-related parameters had limited effects on the cost-effectiveness ratios across sensitivity analyses, and the intervention likewise remained cost-saving compared to no vitamin D under all simulation scenarios.
Interpretation: Vitamin D supplementation may be an efficient use of health care resources for preventing type 2 diabetes in adults with prediabetes.
Funding: Research Ireland (Grant Number: EPSPD/2022/165).
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BibTeX
@article{briody2026costeffectiveness,
title = {{The cost-effectiveness of vitamin D supplementation for the prevention of type 2 diabetes in the United States: a microsimulation modelling study}},
author = {Jonathan Briody and Anastassios G. Pittas and Ping Zhang and Yixue Shao and Edward Gregg},
journal = {Lancet regional health. Americas},
year = {2026},
month = jun,
doi = {10.1016/j.lana.2026.101543},
url = {https://europepmc.org/article/PMC/PMC13728357},
note = {CC BY},
}
RIS
TY - JOUR
TI - The cost-effectiveness of vitamin D supplementation for the prevention of type 2 diabetes in the United States: a microsimulation modelling study
AU - Jonathan Briody
AU - Anastassios G. Pittas
AU - Ping Zhang
AU - Yixue Shao
AU - Edward Gregg
PY - 2026
DA - 2026/06/27
JO - Lancet regional health. Americas
DO - 10.1016/j.lana.2026.101543
UR - https://europepmc.org/article/PMC/PMC13728357
AB - Background: Vitamin D lowers the risk of type 2 diabetes in adults with prediabetes. We assessed the long-term cost-effectiveness of vitamin D supplementation for preventing type 2 diabetes. Methods: We applied a validated microsimulation model to estimate long-term health and economic consequences of vitamin D in a representative cohort of 10,000 U.S. adults with prediabetes in the National Health and Nutrition Examination Survey (NHANES) 2013–2018 cohort. Treatment effects came from individual-participant data of three randomised trials of vitamin D versus placebo (D2d, USA, 2013–2018; DPVD, Japan, 2013–2019; Tromsø, Norway, 2008–2015; pooled analysis 2023). Cost-effectiveness was measured by an incremental cost-effectiveness ratio (ICER) in terms of cost per quality-adjusted life year (QALY) compared to no vitamin D. We conducted subgroup analyses by age, baseline fasting glucose level, body weight, and family history of diabetes. We performed one-way and probabilistic sensitivity analysis. Costs were in 2024 U.S. dollars. 10-year and lifetime time horizons were studied from a U.S. health care system perspective. Findings: In a NHANES-derived cohort of 4176 adults with prediabetes (mean age 53.3 years [SD 17.0]; 2024 [49%] female; 2603 [62%] non-Hispanic White, 488 [12%] non-Hispanic Black, 668 [16%] Hispanic, 417 [10%] other race/ethnicity), vitamin D supplementation reduced per-person lifetime costs by $3208 (95% uncertainty interval [UI] −$5974 to $171), increased lifetime QALYs by 0.12 (95% UI 0.05–0.19), and yielded a lifetime net monetary benefit of $15,483 (95% UI 8108–21,907) at a willingness-to-pay threshold of $100,000/QALY. Life-years gained were 0.27 per person (95% UI 0.06–0.50). Vitamin D reduced the lifetime cumulative incidence of diabetes by 8% (95% UI 6.4–10.6%). Diabetes complications were reduced by an average of 6.4% (95% UI 3.2–8.7%). There were little differences in ICERs across subgroups. Changes in intervention-related parameters had limited effects on the cost-effectiveness ratios across sensitivity analyses, and the intervention likewise remained cost-saving compared to no vitamin D under all simulation scenarios. Interpretation: Vitamin D supplementation may be an efficient use of health care resources for preventing type 2 diabetes in adults with prediabetes. Funding: Research Ireland (Grant Number: EPSPD/2022/165).
SN - 2667-193X
ER -