Cost Effectiveness of Definitive Treatment Strategies for Autonomously Functioning Thyroid Nodules
Authors' conclusion
Based on published data, RAI is most cost-effective in treating most AFTN. Surgery is more cost-effective than RFA in most scenarios, but RFA may be more resource-efficient for smaller nodules with a high likelihood of complete treatment.
Study context
- Population
- Simulated patients with autonomously functioning thyroid nodules (AFTN); model built from published literature, Medicare and RedBook
- Comparison
- Radioactive iodine (RAI) vs thyroid lobectomy vs radiofrequency ablation (RFA)
- Outcome
- Relative cost-effectiveness (cost and cumulative utility in quality-adjusted life years)
- Follow-up
- 2 years
Methodological detailsMarkov model, 2-year time horizon, willingness-to-pay threshold $100,000 per QALY, one-way sensitivity analyses
- Markov model
- 2-year time horizon
- Willingness-to-pay threshold $100,000 per QALY
- One-way sensitivity analyses
Main finding
As reported in the abstract
| Group | Value | Cumulative utility |
|---|---|---|
| RAI | $2000 | 1.89 quality-adjusted life years |
| Lobectomy | $9452 | 1.82 quality-adjusted life years |
| RFA | $10,087 | 1.78 quality-adjusted life years |
Value
RAI$2000
Lobectomy$9452
RFA$10,087
Cumulative utility
RAI1.89 quality-adjusted life years
Lobectomy1.82 quality-adjusted life years
RFA1.78 quality-adjusted life years
Further findings
One-way sensitivity analyses: surgery vs RFA
- RFA more cost-effective than surgery if euthyroidism rate after ablation higher than
- 69% (baseline 54%)
- Relative cost-effectiveness between surgery and RFA driven by probability of euthyroidism after RFA and hypothyroidism after lobectomy
Original publication
Cost Effectiveness of Definitive Treatment Strategies for Autonomously Functioning Thyroid Nodules. Clin Endocrinol (Oxf). Published 1 October 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →