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Published Online: 9 November 2005

Thyroid Hormone Withdrawal in Patients with Differentiated Thyroid Carcinoma: A One Hundred Thirty-Patient Pilot Survey on Consequences of Hypothyroidism and a Pharmacoeconomic Comparison to Recombinant Thyrotropin Administration

Publication: Thyroid
Volume 15, Issue Number 10

Abstract

The study objective was to elucidate clinical, quality-of-life, and pharmacoeconomic effects of hypothyroidism secondary to thyroid hormone withdrawal (withdrawal) in athyroid patients with differentiated thyroid cancer (DTC). We also intended to compare societal costs of withdrawal and recombinant human thyroid-stimulating hormone administration (rhTSH) in this population. We mailed a 13-item pilot survey to patients with DTC who had undergone withdrawal before diagnostic whole-body scan (dxWBS). Using survey results and actual and estimated cost data, we retrospectively constructed a societal cost model comparing withdrawal versus rhTSH and performed a sensitivity analysis by increasing the conservatism of 8 assumptions about withdrawal costs. One hundred thirty (55%) of 236 patients answered the questionnaire. Among respondents, 92% had symptomatic and 85% multisymptomatic hypothyroidism. Almost half sought medical attention for hypothyroid complaints. Approximately one third drove motor vehicles while hypothyroid. Median absence from salaried work was 11 days per withdrawal. In the pharmacoeconomic model, societal costs per dxWBS were approximately €326 (25%) greater for withdrawal than for rhTSH. In the sensitivity analysis, societal costs of rhTSH exceeded those of withdrawal by approximately €307 (30%). In conclusion, hypothyroidism secondary to withdrawal causes important morbidity, safety risks, and productivity impairment. rhTSH avoids these drawbacks at roughly equivalent societal cost to that of withdrawal.

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Published In

cover image Thyroid®
Thyroid
Volume 15Issue Number 10October 2005
Pages: 1147 - 1155
PubMed: 16279848

History

Published online: 9 November 2005
Published in print: October 2005

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    Markus Luster
    Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany.
    Ralph Felbinger
    Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany.
    Markus Dietlein
    Department of Nuclear Medicine, University of Cologne, Cologne, Germany.
    Christoph Reiners
    Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany.

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