Current Evidence and Research Gaps on the Economic Burden of Graves' Disease: A Targeted Literature Review
Moderator
Erin Mandal, Thermo Fisher Scientific, Waltham, MA, United States
Speakers
Lesley-Ann Miller-Wilson; Sarah Ronnebaum, PhD, Evidera, Bethesda, MD, United States; Sofie Norregaard; Nipun Atreja; Kylle Tollefsen
OBJECTIVES: Graves’ disease (GD) is the most common cause of hyperthyroidism and increases the risk of other conditions (eg, heart failure, depression, dementia, diabetes), even among treated patients, imposing a substantial disease burden. We reviewed current evidence describing the burden of GD, including economic impact.
METHODS: A targeted literature review was conducted in PubMed, Medline, the Cochrane Library, and Econlit using a predefined search strategy for articles describing the burden of GD published from January 1, 2019-August 2, 2024. Relevant conference abstracts from January 1, 2021-August 2, 2024 were identified by handsearching. Records describing economic outcomes were included in this analysis.
RESULTS: Among the 2150 records reviewed, 8 were considered relevant. Economic studies from the United States (US; n=2) examined healthcare resource utilization (HCRU) for ≤6 months following total thyroidectomy and lifetime cost-effectiveness of radioactive iodine (RAI) vs thyroidectomy. European studies (n=3) assessed HCRU for ≤100 days with RAI; lifetime costs for antithyroid drugs (ATD), RAI, and thyroidectomy; and the cost-utility of ATD, RAI, and thyroidectomy over 8 years. In China (n=3), 2 studies evaluated HCRU and costs for ATD, RAI, and thyroidectomy over 10 years, and 1 study focused on HCRU and costs associated with agranulocytosis. Evidence from the US and Sweden found thyroidectomy to be more cost-effective than RAI, driven by improved quality of life outcomes with thyroidectomy. Only half of the studies identified reported HCRU and cost estimates for ≥10 years. Findings describing treatment-related costs for GD were inconsistent. No studies examined the contribution of systemic manifestations of GD on overall HCRU or costs.
CONCLUSIONS: Evidence describing the short- and long-term costs and HCRU associated with GD, particularly ATD use, is sparse and limited to the US, northern Europe, and China. Long-term real-world evidence studies are necessary to fully capture the economic burden of GD.
METHODS: A targeted literature review was conducted in PubMed, Medline, the Cochrane Library, and Econlit using a predefined search strategy for articles describing the burden of GD published from January 1, 2019-August 2, 2024. Relevant conference abstracts from January 1, 2021-August 2, 2024 were identified by handsearching. Records describing economic outcomes were included in this analysis.
RESULTS: Among the 2150 records reviewed, 8 were considered relevant. Economic studies from the United States (US; n=2) examined healthcare resource utilization (HCRU) for ≤6 months following total thyroidectomy and lifetime cost-effectiveness of radioactive iodine (RAI) vs thyroidectomy. European studies (n=3) assessed HCRU for ≤100 days with RAI; lifetime costs for antithyroid drugs (ATD), RAI, and thyroidectomy; and the cost-utility of ATD, RAI, and thyroidectomy over 8 years. In China (n=3), 2 studies evaluated HCRU and costs for ATD, RAI, and thyroidectomy over 10 years, and 1 study focused on HCRU and costs associated with agranulocytosis. Evidence from the US and Sweden found thyroidectomy to be more cost-effective than RAI, driven by improved quality of life outcomes with thyroidectomy. Only half of the studies identified reported HCRU and cost estimates for ≥10 years. Findings describing treatment-related costs for GD were inconsistent. No studies examined the contribution of systemic manifestations of GD on overall HCRU or costs.
CONCLUSIONS: Evidence describing the short- and long-term costs and HCRU associated with GD, particularly ATD use, is sparse and limited to the US, northern Europe, and China. Long-term real-world evidence studies are necessary to fully capture the economic burden of GD.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE62
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)