(152) Economic Burden of Management of Pituitary Adenomas: A Propensity-Score-Matched Cost-Analysis

Monday, October 2, 2023

2:45 PM – 3:45 PM East Coast USA Time

Presenting Author(s)

Nick Sahlollbey, BHSc, MD (c)

Medical Student
University of Ottawa
Ottawa, Ontario, Canada

Senior Author(s)

LC

Lisa Caulley, MD, PhD, MPH

Assistant Professor, Otolaryngology-Head and Neck Surgery
University of Ottawa, USA

Co-Author(s)

JS

Jeanne Seguin, MD

Medical Student
University of Ottawa, USA
SJ

Stephanie Johnson-Obaseki, MD

Assistant Professor, Otolaryngology-Head and Neck Surgery
University of Ottawa
Ottawa, Ontario, USA

Senior Author(s)

DS

David Schramm, MD

Head, Department of Otolaryngology / Head and Neck Surgery
University of Ottawa, USA

Co-Author(s)

MD

Mary-Anne Doyle, MD

Assistant Professor, Endocrinology
University of Ottawa, USA

Disclosure(s):

Nick Sahlollbey, BHSc, MD (c): No relevant relationships to disclose.

Introduction: Accurate evaluation of the economic burden of disease is required to improve efficiency in healthcare spending and establish strategies for cost-containment. This study presents a comparative analysis to explore key components of management and direct healthcare costs of pituitary adenomas (PA) in Canada.

Methods: This retrospective, population-based matched cohort analysis used administrative healthcare records to determine the total and incremental cost expenditures associated with PAs between April 2013 and March 2019. Costs were compared to a general population cohort and a hospitalized surgical cohort. Subjects were matched using a propensity-score modelling estimated from baseline characteristics including age, gender, and comorbidities. Cost drivers over time were assessed using negative binomial regression.

Results: Total annual costs for 1,675 patients with PAs were $49,992. Highest total costs were attributed to inpatient hospitalization costs ($24,103), and “OHIP”-related costs ($18,742), particularly due to specialist fees ($17,572). Compared to the general population cohort, total mean annualized costs associated with PA patients were 12.7 (95% CI 10.9 – 14.8, p< 0.0001) times higher during the preadmission and admission period, and remained higher throughout the postoperative follow up period (p < 0.05). The total cost of care for follow up was 37% lower for PA patients as compared to the hospitalized surgical cohort in the first year of follow up (RR 0.63, 95% CI 0.51-0.77; p < .0001), and up to 50% lower in the 5th year of follow up (RR 0.50, 95% CI 0.36 vs 0.68; p < .0001).

Conclusions: Our study was the first to provide an analysis of the economic burden of PAs to other populations of interest. Patients with PAs were found to have higher annualized total costs compared to the general population and lower annualized total costs compared to patients admitted to a surgical ward. The results of this study will inform policy making through identification of the total and incremental costs, and drivers of cost, including the economic impact of surgical populations by resource utilization.