Department of Visceral, Thoracic and Vascular Surgery, Philipps University, Marburg, Germany.
Surgery. 2010 Dec;148(6):1091-9. doi: 10.1016/j.surg.2010.09.009.
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.
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.
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.
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.
随着西那卡塞和帕立骨化醇的引入，继发性甲状旁腺功能亢进的治疗选择有了显著改变。公共卫生系统资源有限，因此需要对不断增加的成本进行详细分析。本研究旨在比较这两种新治疗方法与手术的成本。
分析了 2003 年 1 月至 2006 年 12 月在一家门诊透析中心接受初次甲状旁腺切除术（n = 91）的患者和接受西那卡塞或帕立骨化醇治疗（n = 100）的患者。通过成本-成本分析计算了这两种治疗方法对资金提供者的收入。分析并比较了供应商的实际产生成本和收入。
西那卡塞（60mg/天/年）的治疗费用为 5828.40 欧元，帕立骨化醇（15μg/周/年）的治疗费用为 4485.20 欧元。根据德国 DRG 系统，住院手术治疗的收入为每例 3755.38 欧元。此外，第一年和随后的第一年门诊治疗的费用分别为 545.05 欧元和 384.97 欧元。
由于线性增加，使用西那卡塞治疗超过 9 个月或帕立骨化醇治疗超过 12 个月的医疗费用超过了手术治疗的费用。这些新的医疗疗法的适应证应仅限于手术前的患者或不适合手术的患者作为临时解决方案。
