Length and cost of hospital stay of radioiodine ablation in thyroid cancer patients: comparison between preparation with thyroid hormone withdrawal and thyrogen

  • I. Borget
  • H. Remy
  • J. Chevalier
  • M. Ricard
  • M. Allyn
  • M. Schlumberger
  • G. De Pouvourville
Original article

Abstract

Purpose

Treatment of thyroid cancer consists of thyroidectomy and radioiodine ablation following thyroid-stimulating hormone (TSH) stimulation. Similar ablation rates were obtained with either thyroid hormone withdrawal (THW) or rhTSH. But with rhTSH, the elimination of radioiodine is more rapid, thus reducing its whole-body retention and potentially resulting in a shorter hospital stay. The aim of this study was to assess the financial impact of a reduced length of hospital stay with the use of rhTSH.

Methods

This was a case-control study of thyroid cancer patients treated postoperatively with 3,700 MBq (100 mCi) radioiodine; 35 patients who received rhTSH were matched with 64 patients submitted to THW according to covariates influencing radioiodine retention. The length of hospitalization (LOH) was estimated for each method according to the threshold of radioiodine retention below which the patient can be discharged from the hospital. The economic analysis was conducted from a hospital perspective. Simulations were performed.

Results

For a threshold of 400 MBq, the LOH was 2.4 days and 3.5 days with rhTSH and THW, respectively, and the cost for an ablation stay was, respectively, 2,146 and 1,807 €. In the French context, 57% of the acquisition cost of rhTSH was compensated by the reduction of the length of hospitalization.

Conclusion

By increasing the iodine excretion, rhTSH allows a shorter hospitalization length, which partially compensates its acquisition cost.

Keywords

Thyroid carcinoma rhTSH Thyroid hormone withdrawal Radioiodine ablation Hospital stay Cost 

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • I. Borget
    • 1
  • H. Remy
    • 2
  • J. Chevalier
    • 1
  • M. Ricard
    • 2
  • M. Allyn
    • 3
  • M. Schlumberger
    • 2
  • G. De Pouvourville
    • 4
  1. 1.Detpartment of Health EconomicsInstitut Gustave RoussyVillejuifFrance
  2. 2.Department of Nuclear Medicine and Endocrine OncologyInstitut Gustave Roussy and UniversityVillejuifFrance
  3. 3.Genzyme CorporationCambridgeUSA
  4. 4.Chair of Health EconomicsESSEC Business SchoolCergy-PontoiseFrance

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