On the advice of their GP or specialist, no less than one and a half million Dutch people take vitamin D. Since 1 January, they are no longer reimbursed if they get it from the pharmacy. “We now have daily conversations from people who say: if I have to pay for it myself, I’ll buy it elsewhere,” says pharmacist Kadir Akçay.
The pharmacy where Akçay works has lowered prices by one euro. “Not just so they get it through the pharmacy, but to make sure they get it.”
Otherwise, there is no longer any insight into whether people are still taking it. Akçay is afraid that otherwise patients will not make it at all for financial reasons. Not even at the drugstore, where prices are often higher, he says, and where patients cannot get a combination with calcium.
Vitamin D has been removed from the basic package since 1 January 2023, despite opposition from, among others, senior citizens’ unions and patient associations. Minister Ernst Kuipers (Public Health) adopted the advice of the Care Institute. The supplement would simply be affordable for most people.
For a high dose (75 micrograms) you pay 6.79 for 60 pills. That doesn’t seem like much, but doctors and pharmacists fear that there are people who do need vitamin D and see the cost as a barrier.
For people who now have it on prescription, it is important that they continue to take it. These are, for example, people with brittle bones, or people who have already had a broken bone. Oncological patients also require a higher dose, and patients with impaired renal function. “The risks then are that people are more likely to break their bones.”
Not superfluous
The Royal Dutch Society for the Promotion of Pharmacy (KNMP) also emphasizes how important it is that people continue to take their prescribed vitamin D. “This is a medicine that until recently was prescribed by the general practitioner, which is not superfluous,” says Dennis Mulkens of the KNMP. “We advise people to stay with the pharmacy, if they don’t, we no longer have any insight into it.”
Vitamin D, what about?
Vitamin D is important for our bones, teeth and resistance. An important source of vitamin D is sunlight. “If you go outside between 12:00 and 3:00 pm, with your head and hands uncovered, you usually make enough,” says Annabel Schipper of the KWF.
Sunscreen is important, because even then you still make enough vitamin D in the summer. “You have to go out protected.” And the tanning bed? That’s not a solution.
The KWF has also argued for the supplement to remain in the basic package. Not everyone produces enough vitamin D. Young children, the elderly, people with a dark skin color and pregnant women, for example, are vulnerable groups. “It’s also important for breast cancer patients.”