{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T18:15:26Z","timestamp":1781374526429,"version":"3.54.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T00:00:00Z","timestamp":1685059200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Swedish government","award":["ALFGBG-719531"],"award-info":[{"award-number":["ALFGBG-719531"]}]},{"name":"Swedish government","award":["ALFGBG-966066"],"award-info":[{"award-number":["ALFGBG-966066"]}]},{"DOI":"10.13039\/501100002794","name":"Swedish Cancer Society","doi-asserted-by":"publisher","award":["21 1774 Pj"],"award-info":[{"award-number":["21 1774 Pj"]}],"id":[{"id":"10.13039\/501100002794","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Pituitary adenomas and their consequences impact mortality and morbidity. We studied the healthcare costs, survival, and cost-effectiveness of growth hormone (GH) vs no GH replacement in patients with non-functioning pituitary adenoma (NFPA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design and methods<\/jats:title>\n                  <jats:p>A cohort study including all NFPA patients followed from 1987 or the date of diagnosis until the time of death or December 31, 2019, in the V\u00e4stra G\u00f6taland region, Sweden. Data to assess resource use, costs, survival, and cost-effectiveness were collected from patient records and regional\/national healthcare registries.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 426 patients with NFPA (274 men) with a follow-up of 13.6 \u00b1 6.8 years (mean \u00b1 SD) were included. The total annual healthcare cost was higher in patients receiving GH (\u20ac9287) than those without GH (\u20ac6770), mainly driven by a higher pharmaceutical cost. Glucocorticoid replacement therapy (P = .02), diabetes insipidus (P = .04), body mass index (BMI) (P &amp;lt; .01), and hypertension (P &amp;lt; .01) were all individually associated with a higher total annual cost. The survival rate was higher in the GH group (HR [hazard ratio] 0.60; P = .01) and reduced in patients with glucocorticoid replacement (HR 2.02; P &amp;lt; .01) or diabetes insipidus (HR 1.67; P = .04). The cost per gained life-year for GH vs no GH replacement was about \u20ac37 000.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This healthcare utilization study identified several factors driving the cost of care in NFPA patients, such as GH replacement, adrenal insufficiency, and diabetes insipidus. Life expectancy was increased in those with GH replacement and reduced in patients with adrenal insufficiency and diabetes insipidus.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejendo\/lvad057","type":"journal-article","created":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T09:35:28Z","timestamp":1685093728000},"page":"477-484","source":"Crossref","is-referenced-by-count":10,"title":["Healthcare cost and survival in patients with non-functioning pituitary adenoma"],"prefix":"10.1093","volume":"188","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9734-0786","authenticated-orcid":false,"given":"Daniel S","family":"Olsson","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Sahlgrenska University Hospital , Gothenburg , Sweden"},{"name":"Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden"},{"name":"Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1113-7478","authenticated-orcid":false,"given":"Mikael","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida , Gainsville, FL , United States"},{"name":"School of Public Health & Community Medicine, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5052-1101","authenticated-orcid":false,"given":"Frida","family":"Labori","sequence":"additional","affiliation":[{"name":"School of Public Health & Community Medicine, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"De Geer","sequence":"additional","affiliation":[{"name":"AbbVie AB , Solna , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gudmundur","family":"Johannsson","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sahlgrenska University Hospital , Gothenburg , Sweden"},{"name":"Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,5,26]]},"reference":[{"issue":"6","key":"2023062901154517700_lvad057-B1","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1210\/endrev\/bnac010","article-title":"Clinical biology of the pituitary adenoma","volume":"43","author":"Melmed","year":"2022","journal-title":"Endocr Rev."},{"issue":"4","key":"2023062901154517700_lvad057-B2","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1530\/EJE-14-0144","article-title":"The incidence rate of pituitary adenomas in western Sweden for the period 2001-2011","volume":"171","author":"Tj\u00f6rnstrand","year":"2014","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"2023062901154517700_lvad057-B3","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1007\/s11102-019-00960-0","article-title":"Non-functioning pituitary adenomas: indications for pituitary surgery and post-surgical management","volume":"22","author":"Esposito","year":"2019","journal-title":"Pituitary"},{"issue":"10058","key":"2023062901154517700_lvad057-B4","doi-asserted-by":"crossref","first-page":"2403","DOI":"10.1016\/S0140-6736(16)30053-8","article-title":"Hypopituitarism","volume":"388","author":"Higham","year":"2016","journal-title":"Lancet"},{"issue":"6","key":"2023062901154517700_lvad057-B5","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1111\/joim.13382","article-title":"Growth hormone deficiency in adults with hypopituitarism. 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