Document Detail


An economic comparison of surgical and medical therapy in patients with secondary hyperparathyroidism--the German perspective.
MedLine Citation:
PMID:  21134538     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Treatment options for secondary hyperparathyroidism were significantly amended with the introduction of cinacalcet and paricalcitol. Limitations of resources in public health systems demand detailed analyses of accruing costs. The aim of this study was to compare the costs of these new treatment modalities to surgery.
METHODS: Patients who underwent initial parathyroidectomy (n = 91) and patients treated with cinacalcet or paricalcitol (n = 100) at an ambulatory dialysis center between 01/2003 and 12/2006 were analyzed. The revenues of both therapies for the funding agencies were calculated by a cost-cost analysis. The real arising costs of the supplier were analyzed and compared to the revenues.
RESULTS: Treatment costs for cinacalcet (60 mg/day/year) were 5828.40€ and 4485.20€ for paricalcitol (15 μg/week/year). Revenues for inpatient surgical treatment according to the German DRG system were 3755.38€/case. Additionally, costs for postoperative ambulatory therapies were 545.05€ for the first year and 384.97€ for the following.
CONCLUSION: Due to linearly increases, expenses of medical treatment with cinacalcet for more than 9 months or paricalcitol for more than 12 months exceeded the costs of surgical therapy. The indication of these new medical therapies should be restricted to patients as an interim solution ahead of surgery or in patients considered unfit for surgery.
Authors:
Ralph Schneider; Georgios Kolios; Benjamin M Koch; Emilio Domínguez Fernández; Detlef K Bartsch; Katja Schlosser
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery     Volume:  148     ISSN:  1532-7361     ISO Abbreviation:  Surgery     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-07     Completed Date:  2011-01-14     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1091-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Mosby, Inc. All rights reserved.
Affiliation:
Department of Visceral, Thoracic and Vascular Surgery, Philipps University, Marburg, Germany. Ralph.Schneider@med.uni-marburg.de
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MeSH Terms
Descriptor/Qualifier:
Bone Density Conservation Agents / economics,  therapeutic use
Cost Control / methods
Costs and Cost Analysis / methods
Ergocalciferols / economics,  therapeutic use
Germany
Humans
Hyperparathyroidism, Secondary / drug therapy*,  economics,  epidemiology,  surgery*
Naphthalenes / economics,  therapeutic use
Parathyroidectomy / economics*,  methods,  statistics & numerical data
Chemical
Reg. No./Substance:
0/Bone Density Conservation Agents; 0/Ergocalciferols; 0/Naphthalenes; 131918-61-1/paricalcitol; UAZ6V7728S/cinacalcet

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