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. 2018 Mar;7(2):75-83.
doi: 10.1159/000485973. Epub 2018 Jan 10.

Trends in Costs of Thyroid Disease Treatment in Denmark during 1995-2015

Line Tang Møllehave  1 , Allan Linneberg  1   2   3 , Tea Skaaby  1 , Nils Knudsen  4 , Lars Ehlers  5 , Torben Jørgensen  1   6   7 , Betina Heinsbæk Thuesen  1
Affiliations

Trends in Costs of Thyroid Disease Treatment in Denmark during 1995-2015

Line Tang Møllehave et al. Eur Thyroid J. 2018 Mar.

Abstract

Background: Iodine fortification (IF) may contribute to changes in costs of thyroid disease treatment through changes in disease patterns. From a health economic perspective, assessment of the development in costs of thyroid disease treatment in the population is pertinent.

Objectives: To assess the trends in annual medicine and hospital costs of thyroid disease treatment during 1995-2015 in Denmark, i.e., before and after the introduction of mandatory IF in 2000.

Methods: Information on treatments for thyroid disease (antithyroid medication, thyroid hormone therapy, thyroid surgery, and radioiodine treatment) was obtained from nationwide registers. Costs were valued at 2015 prices using sales prices for medicines and the Danish Diagnosis-Related Group (DRG) and Danish Ambulatory Grouping System (DAGS) tariffs of surgeries/radioiodine treatments. Results were adjusted for changes in population size and age and sex distribution.

Results: The total direct medicine and hospital costs of thyroid disease treatment increased from EUR ∼190,000 per 100,000 persons in 1995 to EUR ∼270,000 per 100,000 persons in 2015. This was mainly due to linearly increased costs of thyroid hormone therapy and increased costs of thyroid surgery since 2008. Costs of antithyroid medication increased slightly and transiently after IF, while costs of radioiodine treatment remained constant. Costs of thyroid hormone therapy and thyroid surgery did not follow the development in the prevalence of hypothyroidism and structural thyroid diseases observed in concurrent studies.

Conclusion: The costs of total direct medicine and hospital costs for thyroid disease treatment in Denmark increased from 1995 to 2015. This is possibly due to several factors, e.g., changes in treatment practices, and the direct effect of IF alone remains to be estimated.

Keywords: Costs and cost analysis; Epidemiology; Health care costs; Iodine; Thyroid diseases.

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Figures

Fig. 1
Fig. 1
Total costs for thyroid disease treatments per 100,000 persons in Denmark. Costs were standardized for changes in population size and age and sex distribution. 2015 prices applied. The vertical line marks the implementation of mandatory iodine fortification in 2000.
Fig. 2
Fig. 2
Costs for antithyroid medication (a), thyroid hormone therapy (b), thyroid surgery (c), and radioiodine treatment (d) per 100,000 persons stratified by region. Costs were standardized for changes in population size and age and sex distribution. 2015 prices applied. The vertical line marks the implementation of mandatory iodine fortification in 2000. ID, iodine deficiency.
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