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CLINICAL STUDY |
Department of Health Economics, Institut de Cancérologie Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif, France, 1 Department of Nuclear Medicine, Centre René Huguenin, Saint-Cloud, France, 2 Department of Nuclear Medicine, Centre Hospitalier Régional Universitaire de Lille, Lille, France, 3 Genzyme Corporation, Cambridge, Massachusetts, USA and 4 Department of Nuclear Medicine and Endocrine Oncology, Institut de Cancérologie Gustave Roussy, Villejuif, France
(Correspondence should be addressed to I Borget; Email: borget{at}igr.fr)
Introduction: The clinical benefits of recombinant human thyroid-stimulating hormone (rhTSH; Thyrogen) are well established as an alternative stimulation procedure to thyroid hormone withdrawal in the diagnostic follow-up of thyroid cancer patients. By avoiding periods of hypothyroidism, patients do not suffer from a decreased quality of life and keep their ability to work. This study compared the frequency, the duration and the cost of sick leave for follow-up control between rhTSH and withdrawal.
Methods: The study population consisted of patients with thyroid carcinoma first treated by thyroidectomy and radioiodine ablation. Patients were recruited at their control visit between October 2004 and May 2006 in three hospitals, both prospectively and retrospectively. Collection data consisted of patient information, job characteristics and duration of sick leave during the month before and the month after control. The valuation of sick leave used the friction cost method.
Results: Among the 306 patients included, 292 (95%) completed the entire questionnaire. The mean age was 46.7 years. Among the 194 active patients, patients treated with rhTSH, when compared with patients treated by withdrawal, were less likely to require sick leave (11 vs 33%; P=0.001). The mean duration of sick leave was shorter (3.1 vs 11.2 days; P=0.002) and indirect costs due to absenteeism accounted for
454 ± 1673 vs
1537 ± 2899 for withdrawal stimulation.
Conclusion: For active patients, rhTSH treatment reduced the length and the cost of sick leave by 8.1 days and
1083 per control respectively, when compared with withdrawal treatment.
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