Cost-effectiveness of using recombinant human thyroid-stimulating hormone before radioiodine ablation for thyroid cancer treatment in Spanish hospitals
| Autor: | M.A. Muros, J.A. Vallejo |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Oncology
medicine.medical_specialty business.industry Cost effectiveness Thyroid Radioiodine ablation General Engineering 030209 endocrinology & metabolism Health benefits medicine.disease Surgery Cost savings 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure 030220 oncology & carcinogenesis Internal medicine medicine General Earth and Planetary Sciences Human thyroid business Thyroid cancer health care economics and organizations General Environmental Science Hormone |
| Zdroj: | Revista Española de Medicina Nuclear e Imagen Molecular (English Edition). 36:362-370 |
| ISSN: | 2253-8089 |
| Popis: | Objectives In thyroid cancer treatment, the thyroid-stimulating hormone (TSH) must be elevated before radioiodine ablation, either by exogenous (with recombinant human thyrotropin [rhTSH]) or endogenous stimulation by thyroid hormone withdrawal (THW). The use of rhTSH avoids hypothyroidism and favours the subsequent elimination of radioiodine, but involves the cost of the product. For this reason, a cost-effectiveness analysis was performed, taking into account all costs involved and the benefits associated with the use of this therapy. Material and methods Using a Markov modelling with two analysis arms (rhTSH and THW), stratified into high (100 mCi/3700 MBq) and low (30 mCi/1110 MBq) radioiodine doses, and using 17 weekly cycles, the incremental cost per quality-adjusted life-year (QALY) related to the use of rhTSH was determined. The clinical inputs included in the model were based on published studies and in a treatment survey conducted in Spain. Results Radioablation preparation with rhTSH is superior to THW, showing additional benefits (0.048 AVAC), as well as cost savings (−614.16 €), with an incremental cost-effectiveness rate (ICER) of −12,795 €/QALY. The univariate and multivariate sensitivity analyses showed the result to be robust. Conclusions The use of rhTSH previous to radioablation in Spain has cost savings, as well as a series of health benefits for the patient, making it highly cost-effective. |
| Databáze: | OpenAIRE |
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