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. 2025 Jul 25:12:186-193.
doi: 10.33393/grhta.2025.3531. eCollection 2025 Jan-Dec.

Micro-costing analysis from Italian Guidelines for the management of sporadic primary hyperparathyroidism

Valentini Ilaria  1   2 , Michele Basile  1 , Fabio Vescini  3 , Giorgio Borretta  4 , Iacopo Chiodini  5   6 , Marco Boniardi  7 , Marina Carotti  8 , Elena Castellano  4 , Cristiana Cipriani  9 , Cristina Eller-Vainicher  10 , Sandro Giannini  11 , Maurizio Iacobone  12 , Antonio Stefano Salcuni  3 , Federica Saponaro  13 , Stefano Spiezia  14 , Annibale Versari  15 , Guido Zavatta  16   17 , Zuzana Mitrova  18 , Rosella Saulle  18 , Alexia Giovanazzi  19 , Roberto Novizio  20 , Agostino Paoletta  21 , Enrico Papini  22 , Agnese Persichetti  23   24 , Irene Samperi  25 , Alessandro Scoppola  26 , Pietro Giorgio Calò  27 , Filomena Cetani  28 , Luisella Cianferotti  29 , Sabrina Corbetta  30   31 , Maria Luisa De Rimini  32 , Alberto Falchetti  5 , Stefano Laureti  33 , Celestino Pio Lombardi  34   35 , Bruno Madeo  36 , Claudio Marcocci  37 , Sandro Mazzaferro  38 , Vittorio Miele  39 , Salvatore Minisola  40 , Andrea Palermo  41   42 , Jessica Pepe  9 , Alfredo Scillitani  43 , Franco Grimaldi  44 , Renato Cozzi  5   45 , Roberto Attanasio  46
Affiliations

Micro-costing analysis from Italian Guidelines for the management of sporadic primary hyperparathyroidism

Valentini Ilaria et al. Glob Reg Health Technol Assess. .

Abstract

Introduction: Primary hyperparathyroidism (PHPT) is a common endocrine disorder, primarily caused by single adenomas or multiglandular disease. This study evaluates the economic impact of different PHPT treatment approaches from both the Italian National Health Service and societal perspectives.

Methods: A micro-costing approach was used to estimate the costs of surgical and non-surgical treatments. Data were gathered through a survey among panel members responsible for the Italian PHPT treatment guidelines, ensuring alignment with national clinical practice. The survey examined various cost components, including diagnostic tests, pre-hospitalization assessments, surgery duration, drug use, healthcare professionals involved, disposable materials, and follow-up care requirements.

Results: The total cost for PHPT diagnosis and comorbidity assessment is € 887.96. Parathyroidectomy (PTX) costs € 4,588.00. Non-surgical alternatives, including pharmacological treatment (€ 953.34 annually) and active surveillance (€ 197.42 annually), result in cumulative 30-year costs of € 28,590 and € 5,910, respectively. Since PTX is typically performed at age 55, pharmacological treatment over 30 years incurs an additional € 22,876 per patient compared to surgery.

Conclusions: Despite its higher upfront cost, PTX demonstrated long-term cost efficiency due to the relatively low rates of follow-up complications and the absence of recurring annual costs associated with conservative strategies.

Keywords: Guidelines; Micro-Costing Analysis; Parathyroidectomy; Primary hyperparathyroidism.

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Conflict of interest statement

Conflicts of Interest: The authors declare no potential conflict of interest to be disclosed.

Figures

FIGURE 1 -
FIGURE 1 -
Tornado diagrams.
See this image and copyright information in PMC

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