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Cost of illness in adult patients with hypopituitarism
C Ehrnborg1, L Hakkaart-Van Roijen, B Jonsson
1Research Centre for Endocrinology and Metabolism, Sahlgrenska University Hospital, Gothenburg, Sweden.
Insights
Patients with hypopituitarism incur significantly higher healthcare costs than the general population, including increased sick leave and disability pension claims. Further research is needed to explore cost-reduction strategies.
Area of Science:
- Endocrinology
- Health Economics
Background:
- Hypopituitarism, a condition of diminished pituitary hormone production, necessitates lifelong hormone replacement therapy.
- Assessing the economic burden of hypopituitarism is crucial for resource allocation and healthcare policy development.
Purpose of the Study:
- To conduct a comparative analysis of healthcare expenditures between patients diagnosed with hypopituitarism and the general population.
- To quantify the direct and indirect health-related costs associated with hypopituitarism.
Main Methods:
- A retrospective cost analysis was performed over a one-year period.
- Direct and indirect costs were estimated for both hypopituitarism patients (n=199) and a matched general population cohort.
- Data were collected from patient records and national registries, adopting a societal perspective.
Main Results:
- Patients with hypopituitarism incurred substantially higher total direct costs (SEK 22,920) compared to the general population (SEK 12,080), with inpatient care being a major contributor.
- A higher proportion of hypopituitarism patients (22%) received disability pensions versus the general population (11.3%).
- Patients with hypopituitarism experienced significantly more sick leave days (38.4 days) than the general population (23.5 days).
Conclusions:
- Hypopituitarism is associated with increased health-related costs, including greater utilization of sick leave and disability benefits.
- The findings underscore the significant economic impact of hypopituitarism on individuals and society.
- Further investigations into optimizing diagnostic, surgical, and therapeutic interventions are warranted to potentially mitigate these healthcare costs.
Objective:
To compare the healthcare costs of patients with hypopituitarism with those of individuals from the general population.
Design:
A retrospective study of costs over 1 year. Estimates of direct and indirect health-related costs were calculated for patients from the general population using existing databases, and for patients with hypopituitarism using records of all patients eligible to participate on 31 December 1989 who could be traced, were willing to participate and had not been treated for acromegaly or Cushing's disease.
Setting:
The catchment area of the Endocrine Unit, Sahlgrenska Hospital, Gothenburg. The study was conducted from the societal perspective. Reference data were collected from official regional and national registries.
Patients:
199 patients with adult-onset hypopituitarism in whom replacement therapy was given to maintain the adrenal, thyroid and gonadal (but not the somatotropic) axes.
Main Outcome Measures And Results:
Direct and indirect costs incurred by patients with hypopituitarism were higher than those incurred by individuals from the general population. The total direct costs per patient were Swedish Crowns (SEK)22,920 vs SEK12,080 (p < 0.003) in the general population, and the highest costs were related to inpatient care. Of the patients aged 16 to 64 years, 22% had drawn a disability pension versus the expected 11.3% (p < 0.003) in the general population, and the patients had a mean sick leave of 38.4 days vs 23.5 (p < 0.001). Total excess costs for all patients with hypopituitarism were SEK 35,768 per patient (p < 0.007).
Conclusions:
Patients with hypopituitarism incur more health-related costs than individuals from the general population. They also take more sick leave days and are more likely to claim a disability pension than members of the general population. Further cost analyses are needed to determine whether improvements in diagnostic and surgical procedures, and hormone replacement therapy, can reduce the healthcare costs of patients with hypopituitarism.