Cost-effectiveness analysis regarding postoperative administration of vitamin-D and calcium after thyroidectomy to prevent hypocalcaemia.
OBJECTIVE
Hypocalcaemia is a frequently arising complication following total thyroidectomy. Routine postoperative prophylactic administration of vitamin D or metabolites and calcium reduce the incidence of symptomatic hypocalcaemia; this article reports evaluating its cost-effectiveness in Colombia.


METHODS
Meta-analysis was used for comparing the administration of vitamin D or metabolites to oral calcium or no treatment at all in patients following total thyroidectomy and a cost-effectiveness analysis was designed based on a decision-tree model with local costs.


RESULTS
The OR value for the comparison between calcitriol and calcium compared to no treatment and to exclusive calcium treatment groups was 0.32 (0.13-0.79 95 %CI) and 0.31 (0.14-0.70 95 %CI), respectively. The most cost-effective strategy was vitamin D or metabolites and calcium administration, having a US $0.05 incremental cost-effectiveness ratio.


CONCLUSIONS
Prophylactic treatment of hypocalcaemia with vitamin D or metabolites + calcium or calcium alone is a cost-effective strategy.
Department of Surgery, School of Medicine, Universidad de La Sabana, Chia, Colombia. alvarosanabria@gmail.com
Alvaro
A
Sanabria
Luis C
LC
Domínguez
Valentín
V
Vega
Camilo
C
Osorio
Daniel
D
Duarte
D002117:Calcitriol / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D002118:Calcium / Q000097:blood; D002119:Calcium Carbonate / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D002125:Calcium Gluconate / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D003105:Colombia; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D016527:Drug Costs; D004630:Emergencies / Q000191:economics; D006801:Humans; D006996:Hypocalcemia / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D011182:Postoperative Care / Q000191:economics*; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D011336:Probability; D013746:Tetany / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D013965:Thyroidectomy
D002117:Calcitriol; D002119:Calcium Carbonate; D002125:Calcium Gluconate; D002118:Calcium