UAE national health insurer drops tests for vitamin D deficiency

Daman will only cover tests for those suspected of having ailments such as osteoporosis, rickets and kidney disorders.

Dr Nazura Siddiqi fears cost calculations will make the problem of vitamin deficiency worse. Delores Johnson / The National
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ABU DHABI // The national health insurer has stopped covering tests for vitamin D deficiency, meaning many who suffer from it may go without treatment.

Daman’s figures show nearly four in five people suffer from vitamin D deficiency, tests for which are crucial, doctors say.

Daman will only cover tests for those with such ailments such as osteoporosis, rickets and kidney disorders.

Those who suffer from malabsorption syndrome and patients who take medication that affect the body’s ability to absorb vitamin D are also covered. Emiratis can still claim the tests, which cost between Dh150 and Dh500, on their Thiqa cards.

Dr Manohar Reddy, a specialist in internal medicine at NMC Specialty Hospital in Abu Dhabi, said many patients who needed the test could now not afford it. He said the halt in coverage was caused by abuse of insurance by patients and health professionals.

“I select the patients who need vitamin D tests,” Dr Reddy said. “I tell them the situation and also explain to them that they will benefit from doing the test.

“In my practice, at least half of my patients have insufficient vitamin D. About 10 per cent of them have very low vitamin D.”

Dr Nazura Siddiqi, specialist obstetrician and gynaecologist at Bareen International Hospital, said many who had vitamin D deficiency did not show symptoms, making checks crucial.

“When they know the test costs about Dh400 they don’t want to get it done,” Dr Siddiqi said.

“There is no way the insurance should not be covering this test. When so many people are affected, we need to monitor it.

“In a country where there is very high prevalence, if people are not getting the tests done, then you’re missing out on all these patients.”

Vitamin D affects the metabolism of almost every cell on the body, she said.

“Vitamin D deficiency affects the heart metabolism, the reproductive system. It can be linked to cardiac problems like high blood pressure and even depression,” Dr Siddiqi said.

“It can also put one at risk of Type 2 diabetes or autoimmune problems. It can be associated with cancer such as colon cancer, prostate cancer, breast cancer.

“We found that vitamin D deficiency can be associated with infertility in women.”

Vitamin D has anti-inflammatory and protective effects, and also helps in absorption of calcium, she said.

Dr Jad Aoun, chief medical officer at Daman, said recent statistics showed 78 per cent of the population had a vitamin D deficiency, and that with such high levels it was “increasingly ineffectual” to carry out tests.

As a result, Daman had altered its position to match “common international best practices”.

Instead, doctors should “focus on measures to increase vitamin D levels through advice on Sun exposure, vitamin D-rich foods or taking supplements”, then follow up to see if symptoms had abated.

“It is important to state that while in some cases the test itself is not covered, the supplements are covered for all,” Dr Aoun said.

“This means that those who have been diagnosed with such a deficiency or have a precondition that requires them to take supplements will be covered on that front by way of a doctor’s prescription.”

Dr Shobha Shetty, specialist in internal medicine at Medeor Medical Centre Al Zeina, believed the high costs of tests and treatment deterred people from seeking diagnosis.

“The expense can go into thousands of dirhams,” Dr Shetty said.

“For a patient earning a meagre amount, they don’t want to spend all their money on this, so we are not able to pick up vitamin D deficiency in the early stages.

“Those who are prone to vitamin D deficiency, we can catch them early rather than waiting for them to go into full-blown deficiency and then treating them. It gets difficult for the doctor and the patient at that stage.”