In primary care, is measuring free-thyroxine plus thyroid-stimulating hormone to detect hypopituitarism cost-effective? A cost utility analysis using Markov chain models.

ABSTRACT:

Objective

We examined whether it is cost-effective to measure free thyroxine (FT4) in addition to thyrotropin (thyroid-stimulating hormone (TSH)) on all requests for thyroid function tests from primary care on adult patients.

Background

Hypopituitarism occurs in about 4 people per 100 000 per year. Loss of thyrotropin (TSH) secretion may lead to secondary hypothyroidism with a low TSH and low FT4, and this pattern may help to diagnose hypopituitarism that might otherwise be missed.

Design

Markov model simulation.

Primary outcome measure

Incremental cost-effectiveness ratio (ICER), the ratio of cost in pounds to benefit in quality-adjusted life years of this strategy.

Results

The ICER for this strategy was £71 437. Factors with a large influence on the IC

SUBMITTER: Shine B 

PROVIDER: S-EPMC6677967 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature