dc.contributor.author | Donovan, Peter | |
dc.contributor.author | McLeod, D. | |
dc.contributor.author | Little, Richard | |
dc.contributor.author | Gordon, Louisa | |
dc.date.accessioned | 2018-10-10T05:58:16Z | |
dc.date.available | 2018-10-10T05:58:16Z | |
dc.date.issued | 2016 | |
dc.identifier.issn | 08044643 | |
dc.identifier.doi | 10.1530/EJE-16-0527 | |
dc.identifier.uri | http://hdl.handle.net/10072/134157 | |
dc.description.abstract | Objective: Little data is in existence about the most cost-effective primary treatment for Graves’ disease.
We performed a cost–utility analysis comparing radioactive iodine (RAI), anti-thyroid drugs (ATD) and total
thyroidectomy (TT) as first-line therapy for Graves’ disease in England and Australia.
Methods: We used a Markov model to compare lifetime costs and benefits (quality-adjusted life-years (QALYs)).
The model included efficacy, rates of relapse and major complications associated with each treatment, and alternative
second-line therapies. Model parameters were obtained from published literature. One-way sensitivity analyses were
conducted. Costs were presented in 2015£ or Australian Dollars (AUD).
Results: RAI was the least expensive therapy in both England (£5425; QALYs 34.73) and Australia (AUD5601; 30.97
QALYs). In base case results, in both countries, ATD was a cost-effective alternative to RAI (£16 866; 35.17 QALYs;
incremental cost-effectiveness ratio (ICER) £26 279 per QALY gained England; AUD8924; 31.37 QALYs; ICER AUD9687
per QALY gained Australia), while RAI dominated TT (£7115; QALYs 33.93 England; AUD15 668; 30.25 QALYs Australia).
In sensitivity analysis, base case results were stable to changes in most cost, transition probabilities and health-relative
quality-of-life (HRQoL) weights; however, in England, the results were sensitive to changes in the HRQoL weights of
hypothyroidism and euthyroidism on ATD.
Conclusions: In this analysis, RAI is the least expensive choice for first-line treatment strategy for Graves’ disease.
In England and Australia, ATD is likely to be a cost-effective alternative, while TT is unlikely to be cost-effective.
Further research into HRQoL in Graves’ disease could improve the quality of future studies. | |
dc.description.peerreviewed | Yes | |
dc.language | English | |
dc.language.iso | eng | |
dc.publisher | BioScientifica | |
dc.relation.ispartofpagefrom | 595 | |
dc.relation.ispartofpageto | 603 | |
dc.relation.ispartofissue | 6 | |
dc.relation.ispartofjournal | European Journal of Endocrinology | |
dc.relation.ispartofvolume | 175 | |
dc.subject.fieldofresearch | Medical and Health Sciences not elsewhere classified | |
dc.subject.fieldofresearch | Clinical Sciences | |
dc.subject.fieldofresearch | Paediatrics and Reproductive Medicine | |
dc.subject.fieldofresearchcode | 119999 | |
dc.subject.fieldofresearchcode | 1103 | |
dc.subject.fieldofresearchcode | 1114 | |
dc.title | Cost-utility analysis comparing radioactive iodine, anti-thyroid drugs and total thyroidectomy for primary treatment of Graves' disease | |
dc.type | Journal article | |
dc.type.description | C1 - Articles | |
dc.type.code | C - Journal Articles | |
gro.hasfulltext | No Full Text | |
gro.griffith.author | Gordon, Louisa | |