Micro-costing analysis from Italian Guidelines for the management of sporadic primary hyperparathyroidism.

IF 0.5 Q4 HEALTH CARE SCIENCES & SERVICES
Global & Regional Health Technology Assessment Pub Date : 2025-07-25 eCollection Date: 2025-01-01 DOI:10.33393/grhta.2025.3531
Valentini Ilaria, Michele Basile, Fabio Vescini, Giorgio Borretta, Iacopo Chiodini, Marco Boniardi, Marina Carotti, Elena Castellano, Cristiana Cipriani, Cristina Eller-Vainicher, Sandro Giannini, Maurizio Iacobone, Antonio Stefano Salcuni, Federica Saponaro, Stefano Spiezia, Annibale Versari, Guido Zavatta, Zuzana Mitrova, Rosella Saulle, Alexia Giovanazzi, Roberto Novizio, Agostino Paoletta, Enrico Papini, Agnese Persichetti, Irene Samperi, Alessandro Scoppola, Pietro Giorgio Calò, Filomena Cetani, Luisella Cianferotti, Sabrina Corbetta, Maria Luisa De Rimini, Alberto Falchetti, Stefano Laureti, Celestino Pio Lombardi, Bruno Madeo, Claudio Marcocci, Sandro Mazzaferro, Vittorio Miele, Salvatore Minisola, Andrea Palermo, Jessica Pepe, Alfredo Scillitani, Franco Grimaldi, Renato Cozzi, Roberto Attanasio
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引用次数: 0

Abstract

Introduction: Primary hyperparathyroidism (PHPT) is a common endocrine disorder, primarily caused by single adenomas or multiglandular disease. This study evaluates the economic impact of different PHPT treatment approaches from both the Italian National Health Service and societal perspectives.

Methods: A micro-costing approach was used to estimate the costs of surgical and non-surgical treatments. Data were gathered through a survey among panel members responsible for the Italian PHPT treatment guidelines, ensuring alignment with national clinical practice. The survey examined various cost components, including diagnostic tests, pre-hospitalization assessments, surgery duration, drug use, healthcare professionals involved, disposable materials, and follow-up care requirements.

Results: The total cost for PHPT diagnosis and comorbidity assessment is € 887.96. Parathyroidectomy (PTX) costs € 4,588.00. Non-surgical alternatives, including pharmacological treatment (€ 953.34 annually) and active surveillance (€ 197.42 annually), result in cumulative 30-year costs of € 28,590 and € 5,910, respectively. Since PTX is typically performed at age 55, pharmacological treatment over 30 years incurs an additional € 22,876 per patient compared to surgery.

Conclusions: Despite its higher upfront cost, PTX demonstrated long-term cost efficiency due to the relatively low rates of follow-up complications and the absence of recurring annual costs associated with conservative strategies.

Abstract Image

意大利散发性原发性甲状旁腺功能亢进治疗指南的微观成本分析。
原发性甲状旁腺功能亢进(PHPT)是一种常见的内分泌疾病,主要由单一腺瘤或多腺疾病引起。本研究从意大利国家卫生服务和社会角度评估了不同PHPT治疗方法的经济影响。方法:采用微观成本法估算手术和非手术治疗的费用。通过对负责意大利PHPT治疗指南的小组成员进行调查收集数据,确保与国家临床实践保持一致。调查审查了各种费用组成部分,包括诊断测试、住院前评估、手术持续时间、药物使用、涉及的医疗保健专业人员、一次性材料和后续护理要求。结果:PHPT诊断及合并症评估总费用为887.96欧元。甲状旁腺切除术(PTX)费用为4,588欧元。非手术替代方案,包括药物治疗(每年953.34欧元)和主动监测(每年197.42欧元),30年累计成本分别为28,590欧元和5,910欧元。由于PTX通常在55岁时进行,与手术相比,30年以上的药物治疗每位患者需要额外支付22,876欧元。结论:尽管PTX的前期成本较高,但由于随访并发症发生率相对较低,并且没有与保守策略相关的经常性年度成本,PTX显示出长期的成本效益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Global & Regional Health Technology Assessment
Global & Regional Health Technology Assessment HEALTH CARE SCIENCES & SERVICES-
CiteScore
0.80
自引率
20.00%
发文量
27
审稿时长
8 weeks
期刊介绍: Global & Regional Health Technology Assessment (GRHTA) is a peer-reviewed, open access journal which aims to promote health technology assessment and economic evaluation, enabling choices among alternative therapeutical paths or procedures with different clinical and economic outcomes. GRHTA is a unique journal having three different editorial boards who focus on their respective geographical expertise.
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