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Time-Driven Activity-Based Cost Comparison of Thyroid Lobectomy and Radiofrequency Ablation
Noel F Ayoub1,2, Karthik Balakrishnan1, Lisa A Orloff2
1Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.
Summary
Radiofrequency ablation (RFA) for benign thyroid nodules is significantly more cost-effective than thyroid lobectomy. This minimally invasive procedure offers lower direct costs, potentially providing higher value for patients when outcomes are similar.
Area of Science:
- Endocrinology
- Surgical Oncology
- Health Economics
Background:
- Radiofrequency ablation (RFA) is an emerging treatment for benign thyroid nodules, known for its effectiveness and minimally invasive approach.
- While RFA shows promise, comprehensive financial comparisons with traditional surgical methods like thyroid lobectomy are limited.
- Understanding the cost implications is crucial for evaluating the overall value of RFA in thyroid nodule management.
Purpose of the Study:
- To conduct a detailed financial analysis comparing the direct costs of thyroid RFA with thyroid lobectomy.
- To accurately measure and contrast the economic impact of these two procedures for benign thyroid nodules.
Main Methods:
- A bottom-up financial cost analysis was performed using time-driven activity-based costing.
- Care cycles for both thyroid lobectomy and RFA were mapped, detailing personnel, time, consumables, and overhead costs.
- Unit-based cost estimates were derived from personnel time, government data for capacity rates, and specific supply/overhead expenses.
Main Results:
- Thyroid lobectomy incurred total costs of $19,229.75 (personnel: $1087.97, supplies: $942.68, overhead: $17,199.10).
- In-office thyroid nodule RFA resulted in significantly lower total costs of $8726.38 (personnel: $379.90, supplies: $1315.28, overhead: $7031.20).
- Overhead costs were identified as the primary cost driver for both procedures.
Conclusions:
- In-office thyroid nodule RFA presents a lower direct cost alternative compared to thyroid lobectomy.
- Given comparable clinical and patient-centered outcomes, RFA may offer superior value for selected patients.
- The findings support RFA as a potentially more economically advantageous treatment for benign thyroid nodules.
