ECONOMIC IMPACT OF AMBULATORY MICROWAVE ABLATION FOR BENIGN THYROID NODULES IN GERMANY
Author(s)
Viktor Makowski, MBA1, Christoph Neumann-Glück, Dr.2, Matthias Heilmann, Herr3, Jörg Hausburg, MBA4, Aline Topouchian, PhD5.
1Market Access Manager, Terumo Deutschland GmbH, Eschborn, Germany, 2Nuklearmedizin Neumann, Leipzig, Germany, 3GVN - GesundheitsVerbund Nord GmbH, Hamburg, Germany, 4TERUMO Europe, Moenchengladbach, Germany, 5Terumo Interventional Systems, Leuven, Belgium.
1Market Access Manager, Terumo Deutschland GmbH, Eschborn, Germany, 2Nuklearmedizin Neumann, Leipzig, Germany, 3GVN - GesundheitsVerbund Nord GmbH, Hamburg, Germany, 4TERUMO Europe, Moenchengladbach, Germany, 5Terumo Interventional Systems, Leuven, Belgium.
OBJECTIVES: Germany is increasingly shifting from inpatient to ambulatory care for procedures suitable for outpatient delivery. Benign thyroid nodules are still frequently treated surgically despite minimally invasive alternatives, with associated hospitalisation, risks, and long-term consequences such as lifelong thyroid hormone replacement therapy. This study evaluates the economic impact of ambulatory microwave ablation (MWA) versus inpatient care from a statutory health insurance perspective.
METHODS: An analysis compared inpatient surgical treatment (DRG-based) with ambulatory MWA delivered via a selective contract. The analysis included all patients treated for benign thyroid nodules (surgical and ablation interventions) across three ICD-10 codes (D34, E04.1, E05.1; n=15,175 in 2024). Inpatient costs were based on weighted DRG reimbursement; ambulatory MWA costs (€2,500 bundled fee) included diagnostics, intervention, anaesthesia, consumables, and follow-up. Scenario analyses assessed budget impact at 30-100% eligibility.
RESULTS: The weighted average inpatient expenditure was €3,682.27 per intervention. Replacing inpatient treatment with ambulatory MWA would result in direct cost savings of €1,182.27 per patient, corresponding to a reduction of approximately 32%. At population level, total inpatient costs were €55.88 million versus €37.92 million for MWA, yielding maximum savings of €17.96 million. Savings ranged from €5.39 million (30% eligibility) to €17.96 million (100%).
CONCLUSIONS: Ambulatory microwave ablation represents a cost-saving minimally invasive intervention alternative to inpatient surgical treatment for benign thyroid nodules in Germany. Selective contracts offer a scalable, quality-assured framework enabling implementation in routine care. Substantial cost savings can be achieved even under conservative adoption scenarios, while the exclusion of downstream cost offsets suggests that the true economics benefit may be underestimated. Broader adoption of ambulatory MWA could support healthcare system efficiency, facilitate the shift toward outpatient care, and improve patient outcomes.
METHODS: An analysis compared inpatient surgical treatment (DRG-based) with ambulatory MWA delivered via a selective contract. The analysis included all patients treated for benign thyroid nodules (surgical and ablation interventions) across three ICD-10 codes (D34, E04.1, E05.1; n=15,175 in 2024). Inpatient costs were based on weighted DRG reimbursement; ambulatory MWA costs (€2,500 bundled fee) included diagnostics, intervention, anaesthesia, consumables, and follow-up. Scenario analyses assessed budget impact at 30-100% eligibility.
RESULTS: The weighted average inpatient expenditure was €3,682.27 per intervention. Replacing inpatient treatment with ambulatory MWA would result in direct cost savings of €1,182.27 per patient, corresponding to a reduction of approximately 32%. At population level, total inpatient costs were €55.88 million versus €37.92 million for MWA, yielding maximum savings of €17.96 million. Savings ranged from €5.39 million (30% eligibility) to €17.96 million (100%).
CONCLUSIONS: Ambulatory microwave ablation represents a cost-saving minimally invasive intervention alternative to inpatient surgical treatment for benign thyroid nodules in Germany. Selective contracts offer a scalable, quality-assured framework enabling implementation in routine care. Substantial cost savings can be achieved even under conservative adoption scenarios, while the exclusion of downstream cost offsets suggests that the true economics benefit may be underestimated. Broader adoption of ambulatory MWA could support healthcare system efficiency, facilitate the shift toward outpatient care, and improve patient outcomes.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE485
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Medical Technologies
Topic Subcategory
Budget Impact Analysis
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), Surgery