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.18.800 +/- 15800 or US$313.33 +/- 263.33). The former cost Rs.10,100 (US$ 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.