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Cited by 10Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryHealth Systems, Economic Evaluations, Quality of Life

The economic impact of switching from synthroid for the treatment of hypothyroidism

Open access
Khandelwal, Nikhil, Johns, Beverly, Hepp, Zsolt, Castelli-Haley, Jane·2018·Journal of Medical Economics
DOI 10.1080/13696998.2018.1443110
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Abstract

AIMS: To compare hypothyroidism-related costs for patients who continuously used Synthroid and patients who switched from Synthroid to alternative therapies. MATERIALS AND METHODS: Truven's Health Analytics MarketScan Commercial Claims and Encounters database from January 1, 2007 to June 30, 2014 was queried for US adults diagnosed with hypothyroidism who initiated Synthroid and adhered to such therapy for at least 6 months. Propensity score matching matched continuous users of Synthroid to patients who switched from Synthroid to alternative levothyroxine agents. Kruskal-Wallis tests assessed differences between the matched cohorts in several categories of costs, including disease-related drug costs, non-drug medical costs, and total direct medical costs. RESULTS: There were 10,159 individuals included in the study, with 7,991 continuous users of Synthroid and 2,168 switchers. After matching (n = 2,052 for each cohort), continuous use of Synthroid was associated with significantly lower hypothyroidism-related non-drug medical costs ($595 vs $1,023; p = .003) and reduced hypothyroidism-related total medical costs ($757 vs $1,132; p = .010), despite being associated with significantly higher drug costs ($161 vs $109; p < .001). Hypothyroidism-related total medical costs rose as the number of switches of hypothyroidism treatment increased, with continuous users having significantly lower hypothyroidism-related total medical costs ($757) compared with patients who switched twice ($1,179; p = .001) or three or more times ($1,268; p = .004). LIMITATIONS: The analyses focused on continuously insured patients who were adherent to Synthroid for at least 6 months and results may not be generalizable. The reliance on claims data does not allow for clinical examination of hypothyroidism or inclusion of some factors that may be associated with outcomes. The analyses assume that all prescriptions filled are taken as prescribed. CONCLUSIONS: Results indicate that there are significant direct economic healthcare costs associated with switching from Synthroid to alternative levothyroxine therapies, and that these costs increase as patients switch therapies more frequently.

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  • Hypothyroid treatment not covered by insurance typically costs €15-€50 per month or €180-€600 per year, depending on dosage, form, country, and brand name.

    “More specifically, hypothyroid treatment that is not covered by insurance typically costs €15–€50 per month or €180–€600 per year, depending on the dosage, form, country, and brand name (35, 36, 37, 38, 39).”

    From ETA guidelines for the use of levothyroxine sodium preparations in monotherapy to optimize the treatment of hypothyroidism (2025) · cites this paper as [35]

    The Results report different drug costs for insured US patients using Synthroid versus those who switched therapies, and the Discussion links lower costs to generic rather than branded medication. Neither section supports the quoted €15–€50 monthly or €180–€600 annual prices for treatment not covered by insurance, or the claimed variation by dosage, form, and country. Page numbers are unavailable in our copy. (LLM, conf=0.83)

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Research works printed but not linked: 3

  1. Generic Pharmaceutical Association. Generic drug savings in the U.S.: Seventh annual edition. GPA; 2015. Washington, DC. Available at: http://www.gphaonline.org/media/wysiwyg/PDF/GPhA_Savings_ Report_2015.pdf
  2. Phillips B, Aziz F, O'Regan CP, et al. Switching statins: the impact of patient outcomes. Br J Cardiol 2007;14:280-5
  3. Truven Health MarketScan Research Databases. Commercial claims and Medicare supplemental: data year 2015 edition. 2016. Ann Arbor, MI: Truven Health Analytics. Available at: https://market- scan.truvenhealth.com/marketscanuniversity/userguide/ 2015%20MarketScanCCAE-MDCRUserGuide.pdf

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Authors
Khandelwal, N., Johns, B., Hepp, Z., & Castelli-Haley, J.
Affiliations
  • AbbVie (United States) (US)
  • AbbVie, Inc., North Chicago, IL, USA
Corresponding author
Hepp, Zsolt
ORCID
Khandelwal, Nikhil
Venue
Journal of Medical Economics
Publisher
Informa UK Limited
Published
2018-03-08
Volume
21
Issue
5
Pages
518-524
ISSN
  • 1369-6998 (ISSN-L)
  • 1941-837X
DOI
10.1080/13696998.2018.1443110
OpenAlex
W2793296442
Cited by
10
References
30
Citations by year
2025: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 2
FWCI
0.99
Type
journal article
Language
en
Open access
Locations
  • Journal of Medical Economics (publishedVersion)
  • PubMed (publishedVersion)
Funders
AbbVie, Inc.
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Keywords
hypothyroidism, levothyroxine, drug switching, health care costs, direct medical costs, drug costs, cost comparison
MeSH terms
Adult, Health Expenditures, Fees, Pharmaceutical, Female, Health Resources, Health Status, Humans, Hypothyroidism, Insurance Claim Review, Male, Middle Aged, Retrospective Studies, Socioeconomic Factors, Thyroxine, Cost of Illness, Models, Economic

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