Comparison of the costs of active surveillance and immediate surgery in the management of low-risk papillary microcarcinoma of the thyroid

Endocrine journal

Hisanori Sasai¹  Tomonori Yabuta²  Minoru Kihara²  Akihiro Miya²  Yasuhiro Ito²  Hitomi Oda²  Hiroo Masuoka²  Mitsuhiro Fukushima²  Kaoru Kobayashi²  Takuya Higashiyama²  Akira Miyauchi² 

[1] Department of Head and Neck Surgery, Kuma Hospital, Center for Excellence in Thyroid Care, Kobe 650-0011, Japan;Department of Surgery, Kuma Hospital, Center for Excellence in Thyroid Care, Kobe 650-0011, Japan

关键词: Papillary microcarcinoma;    Active surveillance;    Surgery;    Medical economics;    Cost;   

DOI  :  10.1507/endocrj.EJ16-0381

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

The incidence of thyroid cancer is increasing rapidly in many countries, resulting in rising societal costs of the care of thyroid cancer.We reported that the active surveillance of low-risk papillary microcarcinoma had less unfavorable events than immediate surgery, while the oncological outcomes of these managements were similarly excellent.Here we calculated the medical costs of these two managements.We created a model of the flow of these managements, based on our previous study.The flow and costs include the step of diagnosis, surgery, prescription of medicine, recurrence, salvage surgery for recurrence, and care for 10 years after the diagnosis.The costs were calculated according to the typical clinical practices at Kuma Hospital performed under the Japanese Health Care Insurance System.If conversion surgeries were not considered, the ‘simple cost’ of active surveillance for 10 years was 167,780 yen/patient.If there were no recurrences, the ‘simple cost’ of immediate surgery was calculated as 794,770 yen/patient to 1,086,070 yen/patient, depending on the type of surgery and postoperative medication.The ‘simple cost’ of surgery was 4.7 to 6.5 times the ‘simple cost’ of surveillance.When conversion surgeries and recurrence were considered, the ‘total cost’ of active surveillance for 10 years became 225,695 yen/patient.When recurrence were considered, the ‘total cost’ of immediate surgery was 928,094 yen/patient, which was 4.1 times the ‘total cost’ of the active surveillance.At Kuma Hospital in Japan, the 10-year total cost of immediate surgery was 4.1 times expensive than active surveillance.

【 授权许可】

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