Comparison of treatment cost and quality-of-life impact of thyroid eye disease therapies - oneGRAVESvoice

Trusted Resources: Evidence & Education

Scientific literature and patient education texts

Back to Evidence & Education / Scientific Articles

Comparison of treatment cost and quality-of-life impact of thyroid eye disease therapies

key information

source: Investigative Ophthalmology & Visual Science

year: 2022

authors: Shreya Ashish Shah, Tracy Lu, Michael Yu, Susan Hiniker, Chrysoula Dosiou, Andrea Lora Kossler


Purpose : Teprotumumab was approved as a treatment for thyroid eye disease (TED) in 2020, but some clinicians question whether its high cost is worth its benefits. Cost-effectiveness analyses (CEAs) can help answer this question, but the health utility scores required are rare in TED. In this study we compare costs of teprotumumab with other treatments and use the validated Graves’ orbitopathy quality-of-life (GO-QoL) score to measure change (Δ) in QoL. Our aim is to help clinicians think critically about treatment costs for TED as health care shifts to focus on cost-effective solutions.

Methods : Analysis was limited to first and second-line therapies for moderate-to-severe active TED (as per the 2021 European Group on Graves Orbitopathy guidelines) with pre- and post-intervention GO-QoL scores available in the literature. The costs of these treatments were obtained from the Turquoise Health database using Medicare billing codes. Prices were then generated from 1,903 hospitals in 50 states. Full treatment costs, including costs of medication and infusion, were calculated using recommended dosing guidelines and standardized to a 70kg patient (Table 1).

Results : Costs of teprotumumab, rituximab, orbital radiotherapy (ORT), and IV methylprednisolone (IVMP) were analyzed. Among these, teprotumumab had the highest mean treatment-related cost at $386,424 (SD $65,217) followed by rituximab at $18,549 (SD $2,556), ORT at $4,316 (SD $1,183), and IVMP at $4,025 (SD $1,647). Teprotumumab yielded a ΔGO-QoL of 19.4 (SD 18.8), rituximab 17.9 (single study), IVMP 13.5 (SD 25.2), and ORT 6.6 (SD 27.8). Treatment cost/ΔGO-QoL for teprotumumab was greatest at $19,888, followed by rituximab at $1,036, ORT at $651, and IVMP at $298 (Table 2).

Conclusions : Treatment cost/ΔGO-QoL of teprotumumab is nearly 20 times that of rituximab and around 50 times that of IVMP. Long-term data regarding the effect of teprotumumab on reducing the rates of orbital and strabismus surgery and improving ocular sequelae, as well as studies evaluating the impact of treatment on QoL using quality-adjusted life years, are needed to be able to determine the cost-effectiveness of the various treatment options for TED.

organization: Stanford University School of Medicine, USA

read more

To improve your experience on this site, we use cookies. This includes cookies essential for the basic functioning of our website, cookies for analytics purposes, and cookies enabling us to personalize site content. By clicking on 'Accept' or any content on this site, you agree that cookies can be placed. You may adjust your browser's cookie settings to suit your preferences. More Information

The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.