Package advice vitamin D

Contents of the National Health Care Institute's advice

The National Health Care Institute recommends that all colecalciferol-containing medicinal products and calcifediol be removed from the GVS. These are the following (groups of) medicinal products: 

• the single products with colecalciferol (ATC code: A11CC05); 
• the fixed combination preparations of colecalciferol/calcium (A12AX);
• the fixed combination preparations of alendronic acid/colecalciferol (M05BB03) and alendronic acid/calcium carbonate/colecalciferol (M05BB05);
• the product calcifediol (A11CC06).

Reason for the advice

Based on a package advice from 2016, a few vitamin D-containing medicinal products have been removed from the GVS. Research by the Netherlands Institute for Health Services Research (Nivel) has shown that for users of vitamin D medicinal products that were removed from the package since 2019 as they could come at own expense, substitution has taken place for vitamin D medicinal products that are still reimbursed via the basic health care package. As a result, the costs for vitamin D medicinal products have not decreased in recent years, but have even increased. Therefore, the Minister of VWS has requested the National Health Care Institute to advice them on vitamin D-products that are still being reimbursed from the GVS.

Colecalciferol (vitamin D3) in low dose is available over the counter as a self-care product at the chemist's or supermarket. In addition, there are colecalciferol medicinal products that are prescribed by a physician and delivered through the pharmacy (high dose, mostly weekly or monthly dosage). At a standard dose of 800 international units (IU; 20 micrograms) per day, vitamin D is available for sale as a self-care product from € 7.30 per person per year. A treatment with colecalciferol on prescription costs on average € 79 per person per year. The costs of vitamin D through reimbursement from the GVS is therefore on average ten times higher than that of a comparable product purchased over the counter. A total withdrawal of all cholecalciferol-containing medicinal products (and calcifediol) from GVS leads to an annual saving of € 129 million on the pharmaceutical budget. For society as a whole, this would mean considerable savings. 

Extension List 2 conditions for other vitamin D

In addition, the National Health Care Institute recommends that List 2 of the Health Insurance Regulation be extended with a new component. This point can be worded as follows: 

This report is a summary of recommendations by the National Health Care Institute. The original text is in Dutch.