VitD testing not covered by Ontario health insurance

[Ivona]

Seems the medical bureacracy does not believe VITD is beneficial in fighting cancer and heart disease.


Read on:

Ontario puts brakes on testing for vitamin D; Evidence doesn't justify cancer-fighting claim, medical advisers say

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Ontario is bucking the vitamin D trend and will no longer pay for testing to determine whether patients are lacking in the supplement, which is being hailed by some as a powerful cancer fighter.

From fighting high blood pressure to protecting against colorectal cancer and boosting the body's immune system, vitamin D is being touted as the latest cure-all.

But that claim is more fiction than fact, said Dr. Les Levin, an oncologist at Princess Margaret Hospital and a member of the Ontario government's medical advisory secretariat - the group responsible for informing the health ministry on latest technologies.

"There is a lot of misinterpretation out there concerning the link between vitamin D and non-bone-related diseases such as cancer and cardiovascular disease," Levin said in an interview.

The popular press, word of mouth and a proliferation of unscientific evidence on the Internet are largely responsible for the claim the vitamin can do many things, Levin said.

"Requests for these tests are escalating rather deeply," he said. "The medical evidence isn't there to justify it."

The U.S. National Cancer Institute, for instance, urges caution in believing the vitamin helps fight certain cancers, Levin said.

According to the health ministry, vitamin D testing in Ontario has skyrocketed by 2,500 per cent since 2004 - from 29,000 tests that year to 700,000 in 2009. The cost has ballooned from $1.7 million in 2004 to $66 million a year, said Health Minister Deb Matthews.

Each test costs $51.70 to carry out.

"Is it about money? Well, we are looking closely at what we fund and making sure what we fund is based on evidence so we can actually spend more money on things that matter," Matthews said.

Ontario is following Manitoba, Nova Scotia, Newfoundland, Prince Edward Island and Saskatchewan, which have all moved to limit unnecessary Vitamin D testing.

Testing will still be available for those with medical conditions such as osteoporosis, rickets, renal disease, osteopenia and malabsorption syndromes.

However, some believe the government is off base in cancelling the funding. Hal Huff, speaking from the clinic at the Canadian College of Naturopathic Medicine at Leslie St. and Sheppard Ave. E., said the test should stay.

"I think it is premature to cease funding," said Huff, a naturopathic doctor. "In my opinion, this is one of the few good nutritional tests."

High-risk groups such as the obese, adults over 50, those who avoid the sun and people with darker skin should be allowed free screening.

"I wouldn't suggest screening be restricted to conditions but (to) groups at greater risk for vitamin D deficiency," he said.

Statistics Canada reports 1.1 million Canadians are deficient in vitamin D.

Evidence is still being examined on the vitamin's role as a cancer protector, Huff said.

"There is an emerging amount of evidence in a lot of diverse fields. The classic focus is on bone health but there is also a lot more research in non-classic areas."

Progressive Conservative MPP Christine Elliott (Whitby-Oshawa) said the Liberals lack a long-term health plan and are making ad hoc decisions as they look for "quick savings."

"This may be counterproductive at the end of the day," Elliott said. "But this is all politically motivated to show the public how they are going to save money. Whether that is a good decision is never really considered."

But if the medical experts who advise the province say unnecessary testing should be curbed, Matthews said she will take their advice.

Ontario is trying to find ways to curb runaway health costs. Forty-six per cent of the provincial budget is spent on health care.

Not only will cutting vitamin D testing for anyone who asks save the province about $64 million a year, Matthews said it will be one less thing for the province's burdened medical laboratories to deal with.

The health ministry has recently cut some bone mineral density and pre-operative testing for cataract surgery.

Matthews also blames the media for an explosion in vitamin D testing.

"People get their health care information from a number of different sources, some more reliable than others," she told the Star. "There's been increased attention here, so people are asking for the test and we currently have no guidelines on who should be funded for the test."

Vitamin D helps maintain normal levels of calcium in the blood. Too little vitamin D can cause calcium levels to drop, leading to calcium being pulled out of bones to stabilize the blood, according to Health Canada.

Calcium is important for strong bones and teeth. Few foods have high levels of natural vitamin D, but sun exposure stimulates the body to produce it.

Vitamin D supplements have been flying off the shelves at the popular vitamin store Supplements Plus at Yonge St. and Eglinton Ave., said Gregory Bagattchouk.

"People know it is good for osteoporosis and your immune system and for those prone to losing calcium like menopausal women," Bagattchouk said.

"We sell many, many brands of vitamin D. Every day we sell at least 10 bottles of it. It is the No. 1 vitamin seller right now."

The vitamin comes in several forms: a water-soluble liquid, tablets, ointments, and in sunflower or olive oil.

"We have it for kids, for adults and in different dosages," Bagattchouk said, attributing its recent surge in popularity to the "media and naturopathic doctors."

Levin said one of the best ways to get the calcium is to do what your mother told you: "People between childhood and age 50 should drink two glasses of milk a day."

The real issue here, he said, is healthy eating and following Canada's Food Guide.

"If we put our energy in that, we'd do a much better job than wait for people's levels to drop," he said.

Adults over age 50 should take a daily vitamin D supplement of 400 international units and follow the food guide, Health Canada says.

Recent changes to OHIP's rules of eligibility

These changes to OHIP's rules of eligibility went into effect on July 1:

The eligibility period for repeat bone mineral density testing for patients at low-risk for osteoporosis. Third and subsequent bone mineral density tests for low-risk individuals are insured by OHIP once every 60 months.

The eligibility period for diagnostic and therapeutic sleep-diagnostic studies are limited to one per 12 months, while therapeutic sleep studies are limited to one every 24 months.

Preoperative electrocardiograms (ECG) and chest -rays when ordered solely for the purposes of preparation for cataract surgery (with no other indication present) are not eligible for payment.

Source: Ontario Ministry of Health and Long-Term Care Compiled by Astrid Lange/ Toronto Star Library