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Multi-modal management of acromegaly: a value perspective
Kristopher T Kimmell1, Robert J Weil, Nicholas F Marko
1The Department of Neurosurgery, University of Rochester Medical Center, 601 Elmwood Avenue, Box 670, Rochester, NY, 14642, USA, kristopher_kimmell@urmc.rochester.edu.
Pituitary
|January 6, 2015
Summary
The Acromegaly Consensus Group guidelines confirm somatostatin analogs as valuable first-line medical therapy for acromegaly. High costs of medical treatments remain a significant factor in their overall value.
Area of Science:
- Endocrinology
- Health Economics
Background:
- Updated guidelines for acromegaly management were recently published.
- Acromegaly requires effective and cost-efficient treatment strategies.
Purpose of the Study:
- To perform a cost analysis of the Acromegaly Consensus Group's medical management guidelines.
- To compare the cost-effectiveness of different acromegaly treatment approaches.
Main Methods:
- Cost analysis utilizing published efficacy rates and public cost data.
- Decision tree modeling based on consensus guidelines and comparative effectiveness.
- Tornado analysis to identify key cost-impact variables.
Main Results:
- Somatostatin analogs are confirmed as valuable first-line medical therapy.
- Dopamine agonist agents also show significant value as upfront therapy.
- Cost of somatostatin analogs and growth hormone receptor antagonists most impacts cost-effectiveness.
Conclusions:
- Surgery offers the greatest value for surgically accessible acromegaly.
- Somatostatin analogs provide the greatest value for medically managed patients.
- High medication costs are the primary limitation for medical acromegaly therapies.
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