open access

Vol 70, No 1 (2019)
Review article
Published online: 2019-02-22
Submitted: 2018-07-05
Accepted: 2018-09-05
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The real costs of acromegaly: analysis of different therapies [Rzeczywiste koszty akromegalii: analiza różnych terapii]

Michał Elbaum, Łukasz Mizera, Marek Bolanowski
DOI: 10.5603/EP.a2018.0080
·
Pubmed: 30843180
·
Endokrynologia Polska 2019;70(1):74-85.

open access

Vol 70, No 1 (2019)
Review article
Published online: 2019-02-22
Submitted: 2018-07-05
Accepted: 2018-09-05

Abstract

Acromegaly is a rare, chronic condition caused by growth hormone (GH) overproduction, usually due to a benign tumour of the pituitary gland. During the disease many complications occur, including cardiovascular disease and changes in the musculoskeletal, respiratory, and endocrine systems. Treatment includes surgery, medical therapy, and radiation. In this paper a literature review was conducted for information related to costs of management of acromegaly and its associated comorbidities using PubMed.The majority of total costs represent pharmacological treatment, especially the most common somatostatin analogues (SSA) therapy. The average reported annual cost of SSA therapy is EUR 12,000–40,000. Surgery reduces the cost of care via the possibility of avoiding lifelong pharmacological treatment. Radiotherapy is also suggested to lower the costs of therapy because about 60% of patients eventually will not require further pharmacological treatment; however, it is connected with negative outcomes like hypopituitarism, lower quality of life, and increased mortality. Cabergoline and pegvisomant are the lowest and highest priced treatments, respectively, but the overall impact on the cost of therapy is minor due to less frequent usage of these drugs. It is hard to fully estimate the impact of comorbidities of acromegaly on financial burden because patients are treated for them many years before the diagnosis of the underlying pathology. The treatment cost of comorbidities is higher in uncontrolled patients. Life-long treatment of acromegaly and its comorbidities is very expensive. Early diagnosis and successful treatment reduce direct and indirect costs. 

Abstract

Acromegaly is a rare, chronic condition caused by growth hormone (GH) overproduction, usually due to a benign tumour of the pituitary gland. During the disease many complications occur, including cardiovascular disease and changes in the musculoskeletal, respiratory, and endocrine systems. Treatment includes surgery, medical therapy, and radiation. In this paper a literature review was conducted for information related to costs of management of acromegaly and its associated comorbidities using PubMed.The majority of total costs represent pharmacological treatment, especially the most common somatostatin analogues (SSA) therapy. The average reported annual cost of SSA therapy is EUR 12,000–40,000. Surgery reduces the cost of care via the possibility of avoiding lifelong pharmacological treatment. Radiotherapy is also suggested to lower the costs of therapy because about 60% of patients eventually will not require further pharmacological treatment; however, it is connected with negative outcomes like hypopituitarism, lower quality of life, and increased mortality. Cabergoline and pegvisomant are the lowest and highest priced treatments, respectively, but the overall impact on the cost of therapy is minor due to less frequent usage of these drugs. It is hard to fully estimate the impact of comorbidities of acromegaly on financial burden because patients are treated for them many years before the diagnosis of the underlying pathology. The treatment cost of comorbidities is higher in uncontrolled patients. Life-long treatment of acromegaly and its comorbidities is very expensive. Early diagnosis and successful treatment reduce direct and indirect costs. 
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Keywords

acromegaly; therapy; costs; pharmacoeconomics

About this article
Title

The real costs of acromegaly: analysis of different therapies [Rzeczywiste koszty akromegalii: analiza różnych terapii]

Journal

Endokrynologia Polska

Issue

Vol 70, No 1 (2019)

Pages

74-85

Published online

2019-02-22

DOI

10.5603/EP.a2018.0080

Pubmed

30843180

Bibliographic record

Endokrynologia Polska 2019;70(1):74-85.

Keywords

acromegaly
therapy
costs
pharmacoeconomics

Authors

Michał Elbaum
Łukasz Mizera
Marek Bolanowski

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