OBJECTIVES: Iodine deficiency can lead to impaired thyroid function and other so called iodine deficiency disorders (IDD). In Germany, more than 30 percent of the population is considered to be mildly to moderately iodine deficient. The economic burden of IDD management is still unclear. The purpose of our study was to compile costs for prevention, monitoring and treatment of IDDs in Germany.

METHODS: We assessed costs for the medical management of IDDs from the German societal perspective (index year 2018). Resource utilization was based on published evidence. Outpatient costs were based on the ‘Uniform Value Scale of the National Association of Statutory Health Insurance Physicians ' and the ‘German Medical Fee Index'. Inpatient costs were based on the 'case fees' of the German Diagnosis Related Groups System. Medication costs are calculated according to reimbursement rules. Indirect costs were based on productivity loss occurring due to disease-related absence from work. Published data and additional expert opinion were used to estimate resource utilization and costs for IDD prevention and monitoring.

RESULTS: Annual average costs per case were EUR 20,792 for intellectual disability; EUR 2,541 for goiter and/or benign thyroid nodules; EUR 4,204 for hyperthyroidism; EUR 2,549 for hypothyroidism; and EUR 10,624 for thyroid cancer. Average costs for miscarriage were EUR 2,182The annual per-person costs in the German population for an IDD prevention program including costs for monitoring, salt iodization, information campaigns and administering and enforcing an iodine fortification program were approximately EUR 0.10.

CONCLUSIONS: Cost for the management of disorders related to iodine deficiency range from EUR 2,182 per case to EUR 20,792 annually. In contrast, prevention costs are low. For recommendations regarding the implementation of an IDD prevention program, effectiveness and epidemiological data needs to be considered in addition in a full economic evaluation, for example, by applying a decision-analytic model.