WASHINGTON, Oct 02, 2003 (United Press International via COMTEX) -- A new
analysis of scientific literature and clinical studies suggests taking a daily
multivitamin can reduce the risk of some disease and healthcare researchers
Thursday recommended it for all adults -- especially seniors. But they threw in
a curve when they based their study figures on Medicare paying for the vitamins
for those over age 65.
Most people think taking a vitamin daily certainly cannot hurt, but no one knows
exactly how much it helps -- specifically, researchers cannot accurately link
decreases in disease risk to taking supplements.
For example, last June, the U.S. Preventive Services Task Force said it found
insufficient evidence to recommend either for or against taking vitamins A, C or
E in supplement form. The same went for multivitamins with folic acid, or for
antioxidant combinations for the prevention of cancer or cardiovascular disease.
Meanwhile, Wyeth Consumer Healthcare of Madison, N.J. -- with 10 percent of the
supplement market in the United States -- contracted with the Lewin Group of
Falls Church, Va., to study the health benefits and cost savings -- in terms of
healthcare expenditures -- of having adults 65 and older take a daily
multivitamin. The resulting report, "Multivitamins and Public Health: Exploring
the Evidence," an analysis of 128 clinical studies and other sources, flies in
the face of the task force's conclusions.
It is estimated only about one-third of Americans take a daily multivitamin.
Most people -- and dieters, seniors or those who are ill in particular -- are
not receiving the daily dosage of vitamins recommended by the American Dietetic
Association, the Lewin Group study authors said. Many people are falling
one-third to one-half short of getting the daily requirements.
"Multivitamins represent a safe, inexpensive, but most importantly, an effective
tool for filling the gap," said Jeffrey Blumberg of Tufts University.
Dr. David Herber of the University of California, Los Angeles, who also
participated in the study, said anyone on low-fat or other restrictive diets,
and those taking in fewer than 1,200 calories a day would "have a tough time
getting all the vitamins and minerals" they need. Many pregnant women also do
not take supplements with folic acid, which can significantly reduce birth
defects.
The study found older adults, who have an increased need for vitamins, can
reduce their risk of cardiovascular disease by 24 percent and improve their
immune system with a daily multivitamin supplement. It went a step further by
factoring in estimates of how those improvements would affect healthcare
spending in Medicare.
For example, in 2004, the study estimated it would cost $149 million to provide
each adult over age 65 with a daily multivitamin.
However, improved immune functions would reduce the costs of hospitalization,
nursing home stays and home health care associated with infections -- such as
pneumonia, urinary tract infections, sepsis -- by an estimated $83 million.
Another $215 million would be slashed from hospitalization costs, the study
concluded, because of less cardiovascular disease, such as heart attacks.
Over five years, even including Medicare program costs, the savings in
healthcare expenditures would amount to $1.62 billion.
Still, Congress is struggling to add a very limited prescription drug benefit to
Medicare. Regardless of the benefits, spending additional program dollars
covering vitamins probably would be resisted in favor of providing the
lifesaving prescription drugs many seniors need but cannot afford. This despite
study estimates that a year's worth of an over-the-counter multivitamin would
cost an average of only $37.
There is a sector of healthcare analysts, however, that thinks preventive
medicine -- which reduces the need for healthcare services -- must play a key
role in lowering costs in a program that will be in serious financial trouble as
the baby boomer generation begins to retire.
Private insurance premiums are increasing yearly by double-digit rates and
insurance companies are using tiered coverage systems, pushing generics and
limiting formularies to be able to provide members with pharmaceutical benefits.
Russ Wilbur, technology coordinator with CareFirst, Blue Cross Blue Shield, told
United Press International specific vitamins to treat specific diseases already
are covered -- such as B12 vitamins for patients suffering from pernicious
anemia -- but not regular multivitamins.
"We would not cover blanket multivitamins because anyone could buy them over the
counter," he said. "They are not for any disease in particular."
Matthew Schiffgens, a spokesman for Kaiser Permanente, also said vitamins are
only covered in some cases, such as fluoride supplements for children in rural
areas where fluoride is not added to the water, and for prenatal care for
expectant mothers.
"We do have multivitamins on the drug formulary here in northern California," he
said. "The clinical appropriateness (of multivitamins) is at the discretion of
the treating physician."
Herber said he has not seen any interest in the private sector yet, but added
that could change as more people begin to use Medical Savings Accounts, to which
they contribute money for healthcare expenditures, and as preventive medicine
becomes more prevalent.
He said there needs to be a public and private effort to educate people about
the value of taking a daily vitamin. Medicare could reach its senior
beneficiaries, along with the American Association of Retired Persons, and more
physicians and other clinicians need to make recommendations to patients.
Even after people agree taking a multivitamin is beneficial to their health, and
even if Medicare or private insurers pay for the vitamins, there still would be
a percentage of people who simply would not take the supplements. Others might
take a daily vitamin for a short time and then stop.
The Lewin study figured if Medicare paid for the vitamins at least 15 percent of
seniors still would not take them daily.
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(UPI's Alexandra Thompson in Washington contributed to this report)
