移植后副甲状腺切除术的时间:一个成本效益分析
Rongzhi Wang1, Stephen Mennemeyer2, Rongbing Xie1
1Department of Surgery, Heersink School of Medicine, University of Alabama at Birmingham, AL.
Surgery
|October 19, 2024
概括
副甲状腺切除术比cinacalcet更具成本效益,用于治疗移植患者的三级甲状腺功能障碍症. 这种手术治疗比使用cinacalcet的长期医疗管理提供了更好的结果,成本更低.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
- 卫生经济学 卫生经济学
背景情况:
- 三级甲状腺功能增强症是接受脏移植的患者常见的并发症.
- 副甲状腺切除术是确定的治疗方法,但cinacalcet提供了一个医疗替代方案.
- 这些策略的比较性成本效益还不清楚.
研究的目的:
- 确定最具成本效益的策略,以管理移植患者的三级甲状腺功能障碍症.
- 从患者的角度来看,比较甲状腺切除术与基于cinacalcet的医疗管理.
主要方法:
- 开发了一种患者级别离散事件模拟模型.
- 该模型模拟了15年时间范围内的结果.
- 成本效益以每年质量调整后的生命年成本来衡量.
主要成果:
- 甲状腺切除术被发现是主要的治疗方法,成本较低 (1315美元对7147美元),有效性更高 (3.17对2.92 QALY).
- 如果辛卡尔塞特治疗超过9个月,副甲状腺切除术变得更具成本效益.
- 增加的cinacalcet成本显著提高了医疗管理的总体开支.
结论:
- 副甲状腺切除术是一种更具成本效益的选择,用于移植后的三级副甲状腺功能障碍症.
- 如果治疗时间延长,基于cinacalcet的治疗可能会超过副甲状腺切除术的成本.
- 在治疗选择的共同决策过程中,应讨论财务影响.
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