Parathyroidectomies have significantly higher costs in secondary hyperparathyroidism
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Parathyroidectomies in secondary hyperparathyroidism result in significantly higher costs and higher rates of morbidity, mortality and complications compared to primary hyperparathyroidism, according to a speaker at the virtual National Kidney Foundation Spring Clinical Meetings.
“While the [parathyroidectomy] PTX surgical procedures are very similar in [primary and secondary hyperparathyroidism] PHPT and SHPT, the cost of PTX in SHPT is significantly higher due to difference in rates of mortality, readmission and reoperation,” Hamza Alshannaq, of the University of Cincinnati, and colleagues wrote in their study abstract.
Alshannaq and colleagues did a search on PubMed and Embase for articles published from January 2000 to June 2019 reporting on costs, rates of PTX procedures or rates or readmission and reoperation after the procedure in patients on hemodialysis with SHPT in the United States, Japan and Europe. Costs were adjusted to a medical component of the 2019 consumer price index.
Results found that of 835 studies, 21 reported rates and costs of PTX for SHPT, four studies reported costs with PTX in the United States and one study reported the total cost of inpatient PTX for 32,971 SHPT patients (mean cost of $21,496). Other studies reported costs of PTX in a mixed population or partial costs as physician charges and medication costs.
Readmission rates varied based on postoperative follow-up within 10 days (3.3%), 30 days (7.9% to 23.8%), 90 days (25%) and 365 days (63%). Reoperation rates ranged from 3.3% to 26% based on follow-up and surgical modality.
“This study provides a historic view of the rates and costs of PTX,” Alshannaq wrote. “There is a need for studies that estimate costs associated with perioperative and postoperative complications and indirect costs. These results could be used to analyze and model how the Medicare CMS policy changes may affect use of calcimimetics and practice patterns.” – by Erin T. Welsh
Reference:
Alshannaq H. Abstract #205. Presented at: National Kidney Foundation Spring Clinical Meetings; March 26-29, 2020 (virtual meeting).
Disclosure: This work was funded by Amgen.
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