Duration and Costs of Hypoparathyroidism After Total Thyroidectomy for Thyroid Cancer: A French Nationwide Claims Database Study (1-YEAR FOLLOW-UP)
Author(s)
Bouee Benhamiche E1, Le Bihan Benjamin C2, Bousquet PJ2, Benmiloud F3
1French National Cancer Institute, Boulogne Billancourt, 92, France, 2French National Cancer Institute, Boulogne-Billancourt, France, 3Hôpital Européen Marseille, Marseille, France
Presentation Documents
OBJECTIVES:
Hypoparathyroidism is the most common complication of total thyroidectomy for thyroid cancer. The resulting hypocalcemia may be transient or permanent and require calcium and/or vitamin D supplementation. Our aim was to investigate the duration of hypoparathyroidism subsequent to the postoperative hypoparathyroidism and assess its 1-year economic burden in France.METHODS:
Adult patients who underwent a total or completion thyroidectomy for cancer between 2011 and 2015 were identified in the French national cancer cohort, including all cancer patients diagnosed since 2010 and based on the large French health insurance claims database (SNDS). Healthcare resource utilization during the 1st postoperative year and costs from the payer’s perspective were assessed. Univariate cost analyses were performed with non-parametric Wilcoxon test, multivariate analyses with generalized linear model (gamma distribution and log link).RESULTS:
Of the 31,175 included patients (75% female, median age: 52y), 13,247 (42%) had hypoparathyroidism (i.e. started calcium and/or vitamin D supplementation within the first postoperative month and/or hospitalized for severe hypocalcemia at any time in the first year). Among the 13,224 patients treated with calcium/vitamin D, 2,855 (22%) continued the treatment at 1 year. Over the first year, mean overall reimbursed expenditures per patient were significantly higher for patients with hypocalcemia than for those without hypocalcemia (€7,233 vs €6,934 p<0.0001): inpatient (€3,038 vs €3,015 p<0.0001), outpatient (€2,883 vs €2,772 p<0.0001) and indirect costs (€1,312 vs €1,147 p<0.0001). After adjusting for age, gender, Charlson Comorbidity index, ecological deprivation index, types of thyroid resection, lymph node dissection and complications, year and region, incremental cost was estimated at €142 (p<0.004).CONCLUSIONS:
Our study showed that hypoparathyroidism after thyroidectomy for cancer leads to an additional cost for health insurance from the 1st year. A 5-year follow-up of patients with permanent hypoparathyroidism is planned to assess long-term complications and their costs.Conference/Value in Health Info
2022-11, ISPOR Europe 2022, Vienna, Austria
Value in Health, Volume 25, Issue 12S (December 2022)
Code
EE590
Topic
Economic Evaluation, Health Policy & Regulatory, Study Approaches
Topic Subcategory
Public Spending & National Health Expenditures
Disease
STA: Surgery