title: Treatment strategies for primary hyperparathyroidism: what is the cost?
abstract: Primary hyperparathyroidism (HPT) contributes to the onset of many chronic conditions. Although parathyroidectomy is the only definitive treatment, observation remains a valid option. Over a 3-year span, a major health plan was queried for HPT and benign parathyroid neoplasm. Patients with secondary and tertiary HPT, Stage III to V kidney disease, and prior renal transplant were excluded. Patients were divided into: observation (Group 1), parathyroidectomy during the study period (Group 2), and parathyroidectomy before the study group (Group 3), and were compared with a control group of 27,092 adult members without HPT using analysis of variance. The 3-year mean total allowed expenditure for Group One (n = 559), Group Two (n = 93), and Group Three (n = 48) were $21,267, $37,043, and $14,702, respectively. Groups One and Two had significantly higher use than the nonparathyroid group (P < 0.0001), whereas that of Group Three was comparable. Group Two had the highest cost, whereas Group Three had a significantly lower cost than Group One (P 0.0001). Primary hyperparathyroidism is associated with a higher use of healthcare resources. Patients observed incurred a higher allowed expenditure than those with prior parathyroidectomy. Surgical treatment may represent a cost-effective strategy for treatment of hyperparathyroidism, although more comprehensive studies are needed to confirm these findings.
authors.affiliation: The Oregon Clinic, Portland, Oregon, USA.
authors.forename: Shaghayegh
authors.initials: S
authors.lastname: Aliabadi-Wahle
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Kelly
authors.forename: Yelena
authors.initials: Y
authors.lastname: Rozenfeld
authors.forename: James R
authors.initials: JR
authors.lastname: Carlisle
authors.forename: Lihau K
authors.initials: LK
authors.lastname: Naeole
authors.forename: Francesca A
authors.initials: FA
authors.lastname: Negreanu
authors.forename: Earl
authors.initials: E
authors.lastname: Schuman
authors.forename: Chet W
authors.initials: CW
authors.lastname: Hammill
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005102:Health Expenditures; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009922:Oregon; D010282:Parathyroid Neoplasms / Q000601:surgery*; D016105:Parathyroidectomy / Q000191:economics*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014861:Washington