{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T20:57:22Z","timestamp":1768769842179,"version":"3.49.0"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,9,19]],"date-time":"2017-09-19T00:00:00Z","timestamp":1505779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,9,19]],"date-time":"2017-09-19T00:00:00Z","timestamp":1505779200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hypoparathyroidism is a potential outcome of anterior neck surgery. Commonly it is managed by calcium and vitamin D supplementation in large doses, with attendant side effects. A recombinant human parathyroid hormone (rhPTH) is now available in the USA, offering a potentially more effective treatment. No cost\u2010effectiveness model investigating this new medication versus standard care has yet been published.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We constructed a decision analytic model comparing usual care versus rhPTH treatment for postsurgical hypoparathyroidism. Threshold and sensitivity analyses on key parameters were conducted to assess robustness of the model. Costs and health outcomes were represented in US dollars and quality\u2010adjusted life\u2010years (QALYs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The rhPTH strategy was both more costly and more effective than the usual care (UC) strategy. In the base case, UC cost $37,196 and provided 7.54 QALYs. The rhPTH strategy cost $777,224 and provided 8.46 QALYs for an incremental cost\u2010effectiveness ratio of $804,378\/QALY. As this was above our willingness\u2010to\u2010pay of $100,000, treatment with rhPTH was not considered cost\u2010effective. The model was robust to all other parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>To our knowledge, this is the first formal cost\u2010effectiveness analysis of rhPTH in comparison with UC. Our model suggests that although the new treatment is slightly more effective than UC, the modest gain in quality of life for patients who are reasonably well\u2010managed by UC does not justify the cost. However, consideration must be given to rhPTH for patients who have failed UC, as the expenditure may be justified in that context.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-017-4248-4","type":"journal-article","created":{"date-parts":[[2017,9,19]],"date-time":"2017-09-19T16:48:42Z","timestamp":1505839722000},"page":"431-436","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Recombinant Parathyroid Hormone Versus Usual Care: Do the Outcomes Justify the Cost?"],"prefix":"10.1002","volume":"42","author":[{"given":"Kathryn H.","family":"Chomsky\u2010Higgins","sequence":"first","affiliation":[{"name":"Department of Surgery, Section of Endocrine Surgery University of California, San Francisco 1600 Divisadero Street, Box 1674 94143 San Francisco CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holly M.","family":"Rochefort","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Endocrine Surgery University of California, San Francisco 1600 Divisadero Street, Box 1674 94143 San Francisco CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn D.","family":"Seib","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Endocrine Surgery University of California, San Francisco 1600 Divisadero Street, Box 1674 94143 San Francisco CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica E.","family":"Gosnell","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Endocrine Surgery University of California, San Francisco 1600 Divisadero Street, Box 1674 94143 San Francisco CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen T.","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Endocrine Surgery University of California, San Francisco 1600 Divisadero Street, Box 1674 94143 San Francisco CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quan\u2010Yang","family":"Duh","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Endocrine Surgery University of California, San Francisco 1600 Divisadero Street, Box 1674 94143 San Francisco CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Insoo","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Endocrine Surgery University of California, San Francisco 1600 Divisadero Street, Box 1674 94143 San Francisco CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,9,19]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp0803050"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015\u20103907"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012\u20101808"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1460215"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013\u20101239"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198\u2010014\u20102677\u20106"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.4158\/EP13321.OR"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015\u20103909"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015\u20103910"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(13)70106\u20102"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265\u2010015\u20100438\u20102"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/14712598.2016.1238455"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014\u20102267"},{"key":"e_1_2_6_15_2","unstructured":"RED BOOK Online(R)\u2014MICROMEDEX\u00ae.http:\/\/www.micromedexsolutions.com\/micromedex2\/librarian\/CS\/54C322\/ND_PR\/evidencexpert\/ND_P\/evidencexpert\/DUPLICATIONSHIELDSYNC\/7310FF\/ND_PG\/evidencexpert\/ND_B\/evidencexpert\/ND_AppProduct\/evidencexpert\/ND_T\/evidencexpert\/PFActionId\/redbook.FindRedBook?navitem=topRedBook&isToolPage=true. 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