Healthcare utilization and costs among patients with non-functioning pituitary adenomas

Lobatto, D.J.; Hout, W.B. van den; Najafabadi, A.H.Z.; Steffens, A.N.V.; Andela, C.D.; Pereira, A.M.; ... ; Vlieland, T.P.M.V. (2019)

Article / Letter to editor

Purpose

Non-functioning pituitary adenomas (NFPA) have a substantial impact on patients’ health

status, yet research on the extent of healthcare utilization and costs among these patients is

scarce. The objective was to determine healthcare usage, associated costs, and their

determinants among patients treated for an NFPA.

Methods

In a cross-sectional study, 167 patients treated for an NFPA completed four validated

questionnaires. Annual healthcare utilization and associated costs were assessed through the

medical consumption questionnaire (MTA iMCQ). In addition, the Leiden Bother and Needs

Questionnaire for pituitary patients (LBNQ-Pituitary), Short Form-36 (SF-36), and EuroQol

(EQ-5D) were administered. Furthermore, age, sex, endocrine status, treatment, and duration

of follow-up were extracted from the medical records. Associations were analyzed using

logistic/linear regression.

Results

Annual healthcare utilization included: consultation of an endocrinologist (95% of patients),

neurosurgeon (14%), and/or ophthalmologist (58%). Fourteen percent of patients had ≥1

hospitalization(s) and 11% ≥1 emergency room visit(s). Mean overall annual healthcare costs

were € 3040 (SD 6498), highest expenditures included medication (31%), inpatient care

(28%), and specialist care (17%). Factors associated with higher healthcare utilization and

costs were greater self-perceived disease bother and need for support, worse mental and

physical health status, younger age, and living alone.

Conclusion

Healthcare usage and costs among patients treated for an NFPA are substantial and were associated with self-perceived health status, disease bother, and healthcare needs rather than

endocrine status, treatment, or duration of follow-up. These findings suggest that targeted

interventions addressing disease bother and unmet needs in the chronic phase are needed.

• All authors: Lobatto, D.J.; Hout, W.B. van den; Najafabadi, A.H.Z.; Steffens, A.N.V.; Andela, C.D.; Pereira, A.M.; Peul, W.C.; Furth, W.R. van; Biermasz, N.R.; Vlieland, T.P.M.V.
• Date: 2019
• Journal: Endocrine
• Volume: 64
• Issue: 2
• Pages: 330 - 340
• DOI: doi:10.1007/s12020-019-01847-7