Does choice of therapy save costs and improve outcomes in hyperthyroid patients?

Objective: To compare cost of treating hyperthyroidism with antithyroid medications (ATD) versus radioactive iodine (RAI). As secondary outcome we also analyzed data in terms of remission rates. Methods: This was a retrospective comparative analysis of hyperthyroid patients treated with ATD or RAI from January 2000 to December 2005. Cost of ATD, TSH. FT4, doctors visits; thyroid technetium scan and RAI treatment were calculated for the duration of treatment and for one year of follow-up after remission. Results: A total of 143 patients were included, with an average duration of follow-up of 32 months. Mean age was 41 ± 15.5 years and M: F' ratio was 1: 2. More expenses were incurred in treating patients with ATD (Rs.28,900 ± 15 400 or US$ 481.67 ± 256.67) than with RAI (Rs.l8.800± 15800 or US$313. 33± 263.33). The former cost Rs.l0,100 (US$ 168.33) more, (p< 0.001; 95%). Remission rate in the RAI group were significantly higher than the ATD group (81.3% vs 49.5%, p=0.006). Conclusion: Treatment of hyperthyroid patients with RAI is not only better in terms of remission of disease, but it is also a more cost effective modality, and should be considered as first line of treatment.