Noori Wahidullah, Sibley Christopher T, Chirikov Viktor V, Roney Kyle, Smith Alden R
Global Health Economics and Outcomes Research, Ascendis Pharma, Inc., 1000 Page Mill Rd., Palo Alto, CA, 94304, USA.
Clinical Development, Ascendis Pharma, Inc., 1000 Page Mill Rd., Palo Alto, CA, 94304, USA.
Adv Ther. 2025 Jun 18. doi: 10.1007/s12325-025-03265-w.
Approximately 75% of hypoparathyroidism (HypoPT) cases result from removal of or injury to parathyroid glands during anterior neck surgery. HypoPT persisting 6 months following surgery carries a significant economic burden. This study aims to describe the economic burden of postsurgical chronic HypoPT in the Medicare population.
Data from the Medicare 100% Limited Data Set between July 1, 2017, and March 31, 2020, were utilized to identify newly diagnosed adults with a confirmed HypoPT diagnosis (n = 1,166) after surgery (index) and their healthcare resource utilization (HCRU) and costs compared with those of control patients who were non-HypoPT (n = 11,258). Continuous enrollment for ≥ 6 months pre- and ≥ 12 months post-index was required. Individuals with postsurgical chronic HypoPT were matched 1:2 to controls on age, gender, race, region, Charlson Comorbidity Index score, and index year. Three economic burden definitions for HCRU and costs were evaluated in unmatched and matched groups: all-cause, direct HypoPT, and HypoPT plus related long-term complications.
Compared with matched controls (n = 1,107), individuals with postsurgical chronic HypoPT (n = 607) had significant differences in baseline number of hospitalizations (0.53 vs. 0.14), outpatient visits (11.40 vs. 1.51), and total medical costs (US$160,899 vs. $21,288). Over a median of 31 months of follow-up, mean all-cause total medical costs per patient per year (PPPY) were significantly higher among individuals with postsurgical chronic HypoPT ($227,036 vs. $109,306; P < 0.001), largely attributable to higher all-cause medical utilization among the postsurgical chronic HypoPT group (0.72 vs. 0.37 hospitalizations PPPY; 14.4 vs. 7.44 outpatient visits PPPY). Multivariable regression analysis showed that all-cause cost burden among patients with postsurgical chronic HypoPT was 1.57-3.00 times higher, depending on adjustment for baseline renal comorbidities, compared with controls.
The economic burden of postsurgical chronic HypoPT in patients who use Medicare is substantial, highlighting the need for innovative treatments to improve outcomes and quality of life.
约75%的甲状旁腺功能减退症（HypoPT）病例是由于前颈部手术中甲状旁腺被切除或受损所致。术后持续6个月的甲状旁腺功能减退症会带来巨大的经济负担。本研究旨在描述医疗保险人群中术后慢性甲状旁腺功能减退症的经济负担。
利用2017年7月1日至2020年3月31日医疗保险100%有限数据集的数据，确定术后确诊为甲状旁腺功能减退症的新诊断成年人（n = 1166）（索引病例），并将其医疗资源利用（HCRU）和成本与非甲状旁腺功能减退症的对照患者（n = 11258）进行比较。要求在索引前连续登记≥6个月，索引后连续登记≥12个月。将术后慢性甲状旁腺功能减退症患者与对照患者按年龄、性别、种族、地区、查尔森合并症指数评分和索引年份进行1:2匹配。在未匹配和匹配组中评估了HCRU和成本的三种经济负担定义：全因、直接甲状旁腺功能减退症以及甲状旁腺功能减退症加相关长期并发症。
与匹配的对照患者（n = 1107）相比，术后慢性甲状旁腺功能减退症患者（n = 607）在基线住院次数（0.53对0.14）、门诊就诊次数（11.40对1.51）和总医疗费用（160899美元对21288美元）方面存在显著差异。在中位31个月的随访期内，术后慢性甲状旁腺功能减退症患者的人均每年全因总医疗费用（PPPY）显著更高（227036美元对109306美元；P < 0.001），这主要归因于术后慢性甲状旁腺功能减退症组更高的全因医疗利用率（PPPY住院次数0.72对0.37；PPPY门诊就诊次数14.4对7.44）。多变量回归分析表明，根据对基线肾脏合并症的调整情况，术后慢性甲状旁腺功能减退症患者的全因成本负担比对照患者高1.57至3.00倍。
使用医疗保险的患者术后慢性甲状旁腺功能减退症的经济负担巨大，这突出表明需要创新治疗方法来改善治疗效果和生活质量。
