Evidence map›Paper›PMID 24793247›Full record

ArticleBMJ open2014

Should vitamin B12 tablets be included in more Canadian drug formularies? An economic model of the cost-saving potential from increased utilisation of oral versus intramuscular vitamin B12 maintenance therapy for Alberta seniors.

Sherilyn K D Houle, Michael R Kolber, Anderson W Chuck

Open access · goldAbstract readComparative Study
In one paragraph

Article in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
0.5field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Oral vitamin BThe Cochrane database of systematic reviews · 2018
    Pooled it
  3. Trial
  4. Vitamin BNutrients · 2026
    Review
  5. Vitamin BMolecules (Basel, Switzerland) · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 1 country.

Sherilyn K D HouleSchool of Pharmacy, University of Waterloo, Waterloo, Alberta, Canada.
Michael R Kolber
Anderson W Chuck
Institute of Health Economics · CAUniversity of Alberta · CAUniversity of Waterloo · CA

Funding

Canadian Institutes of Health Research
6 · The paper itself

Abstract

objectiveThe aim of this study was to estimate the cost-savings attainable if all patients aged ≥65 years in Alberta, Canada, currently on intramuscular therapy were switched to oral therapy, from the perspective of a provincial ministry of health.

settingPrimary care setting in Alberta, Canada.

participantsSeniors of age 65 years and older currently receiving intramuscular vitamin B12 therapy.

interventionOral vitamin B12 therapy at 1000 μg/day versus intramuscular therapy at 1000 μg/month. PRIMARY AND SECONDARY OUTCOME MEASURES: Cost saving from oral therapy over intramuscular therapy, from the perspective of the Alberta Ministry of Health, including drug costs, dispensing fees, injection administration fees, additional laboratory monitoring and physician visit fees.

resultsOver 5 years, if all Albertans aged 65 years and older who currently receive intramuscular B12 are switched to oral therapy, our model found that $C13 975 883 can be saved. Even if no additional physician visits are billed for among patients receiving intramuscular therapy, $C8 444 346 could be saved from reduced administration costs alone.

conclusionsOral B12 therapy has been shown to be an effective therapeutic option for patients with vitamin B12 deficiency, yet only three provinces and the Non-Insured Health Benefits program include oral tablets on their formulary rather than the parenteral preparation. To ensure judicious use of limited health resources, clinicians and formulary committees are encouraged to adopt oral B12 therapy as a clinically and cost-effective first-line therapy for vitamin B12 deficiency.

Indexed as

Cost SavingsFormularies as TopicModels, EconomicAdministration, OralAgedAlbertaDrug CostsDrug UtilizationHumansInjections, IntramuscularTabletsVitamin B 12Vitamin B ComplexTabletsVitamin B 12Vitamin B ComplexHealth EconomicsPrimary Care

Identifiers

PMID24793247
PMCPMC4025453
OpenAlexW2166812386

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.