德国碘缺乏病预防、监测及治疗策略的经济影响

The economic impact of prevention, monitoring and treatment strategies for iodine deficiency disorders in Germany.

作者信息

Schaffner Monika, Rochau Ursula, Mühlberger Nikolai, Conrads-Frank Annette, Qerimi Rushaj Vjollca, Sroczynski Gaby, Koukkou Eftychia, Thuesen Betina Heinsbaek, Völzke Henry, Oberaigner Wilhelm, Siebert Uwe

机构信息

Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria.

Faculty of Pharmacy, School of PhD Studies, Ss. Cyril and Methodius University, Skopje, Macedonia.

出版信息

Endocr Connect. 2021 Jan;10(1):1-12. doi: 10.1530/EC-20-0384.

DOI:10.1530/EC-20-0384

PMID:33263563

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7849460/

Abstract

OBJECTIVE

More than 30% of the German population suffers from mild to moderate iodine deficiency causing goiter and other iodine deficiency disorders (IDDs). The economic burden of iodine deficiency is still unclear. We aimed to assess costs for prevention, monitoring and treatment of IDDs in Germany.

DESIGN

We performed a comprehensive cost analysis.

METHODS

We assessed direct medical costs and direct non-medical costs for inpatient and outpatient care of IDDs and costs for productivity loss due to the absence of work in 2018. Additionally, we calculated total costs for an IDD prevention program comprising universal salt iodization (USI). We performed threshold analyses projecting how many cases of IDDs or related treatments would need to be avoided for USI to be cost-saving.

RESULTS

Annual average costs per case in the year of diagnosis were € 211 for goiter/thyroid nodules; € 308 for hyperthyroidism; and € 274 for hypothyroidism. Average one-time costs for thyroidectomy were € 4184 and € 3118 for radioiodine therapy. Average costs for one case of spontaneous abortion were € 916. Annual costs of intellectual disability were € 14,202. In the German population, total annual costs for USI would amount to 8 million Euro. To be cost-saving, USI would need to prevent, for example, 37,900 cases of goiter/thyroid nodules.

CONCLUSION

USI potentially saves costs, if a minimum amount of IDDs per year could be avoided. In order to recommend the implementation of USI, a full health-economic evaluation including a comprehensive benefit-harm assessment is needed.

摘要

目的

超过30%的德国人口患有轻度至中度碘缺乏症，导致甲状腺肿大和其他碘缺乏疾病（IDD）。碘缺乏的经济负担仍不明确。我们旨在评估德国IDD预防、监测和治疗的成本。

设计

我们进行了全面的成本分析。

方法

我们评估了2018年IDD住院和门诊护理的直接医疗成本和直接非医疗成本以及因缺勤导致的生产力损失成本。此外，我们计算了包括全民食盐加碘（USI）在内的IDD预防计划的总成本。我们进行了阈值分析，预测需要避免多少例IDD或相关治疗才能使USI节省成本。

结果

诊断当年每例甲状腺肿大/甲状腺结节的年平均成本为211欧元；甲状腺功能亢进为308欧元；甲状腺功能减退为274欧元。甲状腺切除术的平均一次性成本为4184欧元，放射性碘治疗为3118欧元。一例自然流产的平均成本为916欧元。智力残疾的年度成本为14202欧元。在德国人口中，USI的年度总成本将达到800万欧元。为了节省成本，例如，USI需要预防37900例甲状腺肿大/甲状腺结节。