Cost-effectiveness Analysis Of The Treatment Of Acromegaly Quality Of Life Of Its Cross-sectional Survey

Background Many studies have showed that GH levels at the time of diagnosis and tumor size are predictive of surgical outcomes in patients with acromegly, and therefore, any therapy that decrease GH levels and tumor size before surgery would have a theoretical advantage. We estimated the cost effectiveness of two therapeutic schemes: preoperative medical therapy followed by surgery and surgery as primary therapy.Methods Retrospective analysis of168cases. We estimated the cost per year of life gained and the cost per quality-adjusted years of life gained with the two therapeutic schemes. To estimate the cost and the effects, Makov models were used.Results In the patients with macroadenoma, the remission rate of the therapeutic scheme of preoperative medical therapy followed by surgery is higher than that of surgery as primary therapy. We modeled three different treatments after surgery using Makov model, and we found that as for macroadenoma, the cost per year of life gained and the cost per quality-adjusted years of life gained with the therapeutic scheme of preoperative medical therapy followed by surgery are higher than that of the therapeutic scheme of surgery as primary therapy in the subgroup of secondary surgery. However, the cost per year of life gained and the cost per quality-adjusted years of life gained with the therapeutic scheme of preoperative medical therapy followed by surgery are lower than that of the therapeutic scheme of surgery as primary therapy in the subgroup of radiotherapy and drug therapyConclusions In acromegalic patients with macroadenoma, the therapeutic scheme of preoperative medical therapy with long acting SSA followed by surgery is cost effective. Objective:The aim of this study was to evaluate the quality of life(QOL) in patients with treated acromegaly and its influential factors.Design:cross-sectional study.Metods:We used the Acromegaly Quality of Life Questionnaire(ACROQoL). to evaluate QOL in patients with treated acromgaly.61patients wre divided into controlled and uncontrolled groups based on the remission criteria and further subdivided into eight groups according to with/without complications or radiotherapy. Comparisons between groups were analyzed.Results:In comparison with the uncontrolled groups, the controlled groups showed better ACROQoL scores in psychological subscale "appearance"(P=0.044). And in subgroups, only the subgroup of with complications in controlled group was found to have higher scores in psychological subscale "personal relationship" than the subgroup of without complications.Conclusions:Acromegaly has an important impact on quality of life. The level of GH is negatively associated with psychological subscale "appearance" in patients with acromegaly.