COST-EFFECTIVNESS ANALYSIS OF TOTAL THYROIDECTOMY VS RADIOIODINE FOR GRAVES DISEASE
Abstract
Among the patients suffering from hyperthyroidism 60-80% of them suffers from Graves’ disease. The initial therapies of Graves’s disease are antithyroid drugs. If the remission isn’t achieved after 12-18 months, patients should be directed to surgical treatment or to the therapy with radioactive iodine. The goal of this paper was to determine better ratio of costs to clinical effectiveness between radioactive iodine and total thyroidectomy. The analysis was done using TreeAge Pro® software. The duration of one cycle is six months, and time horizon of observation is 30 years. Monte Carlo simulation was performed for 1000 virtual patients as well as the analysis of sensitivity with the variation of parameters ± 50%. For total thyroidectomy one should provide 138.389,72 RSD / 57, 83 QALY i.e. 2.393,0437 dinars for one gained quality-adjusted life year, and for radioactive iodine one should provide 110.043,64 RSD / 57,82 QALY i.e. 1.903,369 dinars for one gained quality-adjusted life year. This pharmacoeconomic analysis showed that radioactive iodine has better ratio of costs to clinical effectiveness as opposed to total thyroidectomy.
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