Cost comparison between open thyroid lobectomy and radiofrequency ablation for management of thyroid nodules

Abstract

Background: There is an increasing array of treatment options for addressing clinically significant thyroid nodules, including radiofrequency ablation (RFA). While effective, the cost compared to alternative approaches has not been well elucidated.Methods: This study involved a retrospective chart review, focusing on variable direct cost (VDC) of each procedure, from April 2016 to January 2020. We analyzed costs for 53 open lobectomies and 16 RFA procedures. Results: Cost effectiveness depended on the simulated cost of the RFA probe.In comparison to open lobectomy, the VDC to perform RFA was $597 (19%) cheaper when the simulated probe cost was $1500 and $403 (13%) more expensive for a probe cost of $2500. Statistical significance was achieved for both these differences. Conclusions: If cost per RFA probe can be less than $2100-the break-even dollar amount between open lobectomy and RFA-there would be considerable cost savings for treating thyroid nodules.

General Principles for the Safe Performance, Training, and Adoption of Ablation Techniques for Benign Thyroid Nodules: An American Thyroid Association Statement

“…Given the lack of a Current Procedural Terminology (CPT) code and inconsistency in reimbursement, charges for TA procedures are largely dependent on institutional policies and are highly variable. Two recent studies have established that RFA of benign nodules can be a cost-effective treatment if the cost of the RFA electrode is kept below $2100 65 and the overall cost of treatment kept below $17,950 USD. 66 Additional billing considerations for TA procedures are listed in Table 5 .…”

Time‐Driven Activity‐Based Cost Comparison of Thyroid Lobectomy and Radiofrequency Ablation

“…That study, however, did not account for personnel costs or differences in overhead costs between the operating room and clinic. 16 RFA is not an appropriate treatment option for all patients, and there are some known limitations to its use. 1 RFA does not permit additional pathological analysis of the thyroid nodules, which may be particularly important in the case of indeterminate cytology.…”

“…Miller et al's retrospective study looked at variable direct costs of lobectomy and RFA and showed that the cost of the RFA probe dictated whether RFA was more or less expensive than thyroid lobectomy. That study, however, did not account for personnel costs or differences in overhead costs between the operating room and clinic 16 …”