title: Cost-effectiveness analysis of two therapeutic schemes in the treatment of acromegaly: a retrospective study of 168 cases.
abstract: OBJECTIVE
  This study aimed to estimate the cost effectiveness of two therapeutic schemes, including preoperative medical therapy and surgery as primary therapy.
  
  
  METHODS
  A total of 168 acromegaly cases were retrospectively investigated for a comparative evaluation of surgery and preoperative medical therapy. A Markov model was developed to simulate treatment cost-effectiveness and progression of acromegaly.
  
  
  RESULTS
  Overall effectiveness of preoperative medical therapy was significantly higher than surgery in acromegalic patients with macroadenoma. In addition, life expectancy, and cost per life-year gained were slightly higher in the preoperative medical therapy group than in the initial surgery group when patients received surgery as a secondary treatment. Interestingly, preoperative medical therapy achieved a significant increase in life expectancy and reduced cost for patients who received long-term medical therapy as secondary treatment.
  
  
  CONCLUSIONS
  In acromegalic patients with macroadenoma, the cost-effectiveness analysis revealed more satisfactory outcomes in preoperative therapy, compared with primary surgery.
authors.affiliation: Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 100730, Beijing, China.
authors.forename: L
authors.initials: L
authors.lastname: Duan
authors.affiliation: The Cardiology Department, Nanfang Hospital, 510515, Guangzhou, China.
authors.forename: M
authors.initials: M
authors.lastname: Huang
authors.affiliation: Orthopedic Department, The Third Affiliated Hospital of Southern Medical University, 510630, Guangzhou, China.
authors.forename: H
authors.initials: H
authors.lastname: Yan
authors.affiliation: Department of National Health Accounts and Policy Studies, China National Health Development Research Center, 100191, Beijing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 100730, Beijing, China. shisimedsci@163.com.
authors.forename: F
authors.initials: F
authors.lastname: Gu
mesh_terms: D000172:Acromegaly / Q000188:drug therapy / Q000191:economics / Q000601:surgery; D000236:Adenoma / Q000188:drug therapy / Q000191:economics / Q000601:surgery; D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000191:economics; D010911:Pituitary Neoplasms / Q000188:drug therapy / Q000191:economics / Q000601:surgery; D012189:Retrospective Studies
keywords: Acromegaly; Cancer therapy; Cost-effectiveness analysis; Macroadenoma; Markov model; Retrospective analysis