Impact of vitamin D non-reimbursement policy on therapy discontinuation in the general and rheumatic population in the Netherlands: a cross-sectional study.

A small proportion of patients discontinued vitamin D therapy following the non-reimbursement policy implementation.

• Of 4800 patients included, 302 (6.4%) discontinued their vitamin D supplementation therapy following implementation of the non-reimbursement policy.
• Data were collected between April and May 2023 through self-reported questionnaires.
• The study included patients from both the general and rheumatic populations with an active prescription for vitamin D supplementation therapy.
• Patients were recruited from a research institute specialised in health research and two outpatient pharmacies in the Netherlands.

The three most frequently reported reasons for therapy discontinuation were financial and informational barriers.

• The most common reasons were the inability to afford supplements without reimbursement, not willing to pay for supplements without reimbursement, and being unaware of the alternative vitamin D supplements to switch to.
• These reasons were identified through patient-reported questionnaire responses.
• Financial constraints were both a reported reason and a statistically significant predictor of discontinuation (p<0.05).

Younger age, financial constraints, and limited health literacy were significantly associated with vitamin D therapy discontinuation.

• All three patient-related characteristics were statistically significant predictors of discontinuation (p<0.05).
• Patients aged <50 years showed elevated discontinuation rates compared to older patients.
• Logistic regression was performed using STATA V. 17 to assess associations between patient-related characteristics and risk of therapy discontinuation.
• A p value <0.05 was considered statistically significant.

Among patients who switched to an alternative supplement, a minority did so in consultation with a healthcare provider.

• 1478 patients switched to an alternative supplement following the non-reimbursement policy.
• Of those who switched, 706 (17.9%) indicated that they made the switch in consultation with a healthcare provider.
• This implies that the majority of patients who switched (approximately 82.1%) did so without consulting a healthcare provider.

The study design was cross-sectional, using self-reported questionnaire data from a Dutch patient population.

• The study included 4800 patients total with an active prescription for vitamin D supplementation therapy.
• Patients came from both a research institute specialised in health research and two outpatient pharmacies in the Netherlands.
• Data collection occurred between April and May 2023.
• Descriptive statistics and logistic regression were used for analysis.