OBJECTIVES: To examine the cost of central laboratory-based intraoperative parathyroid hormone (PTH) during parathyroid surgery compared with a point of care-based PTH testing system. METHODS: Based on a retrospective analysis of intraoperative PTH testing in 50 parathyroid surgeries, a cost comparison between the current testing system at a university-affiliated tertiary care facility (Elecsys 1010, Roche Diagnostics, Basel, Switzerland) and a theoretical model using the QuiCK-intraoperative intact PTH system (Nichols Institute Diagnostics, San Juan Capistrano, CA) was generated. RESULTS: The cost per surgery of central laboratory-based PTH testing was $129.15 compared with $550.98 for the point of care-based system. Costs were calculated accounting for the purchase price of equipment, cost of reagents and processing, and laboratory technician time. CONCLUSIONS: This is the first cost comparison study using a Canadian-based health care model for point of care versus central laboratory PTH testing and adds to a very limited number of cost comparison studies on this topic. This study provides evidence that in the setting of a tertiary care facility that has on-site laboratory facilities with dedicated staff, central laboratory-based PTH assays provide an efficient and cost-effective way of monitoring PTH levels during parathyroidectomy surgery.
OBJECTIVES: To examine the cost of central laboratory-based intraoperative parathyroid hormone (PTH) during parathyroid surgery compared with a point of care-based PTH testing system. METHODS: Based on a retrospective analysis of intraoperative PTH testing in 50 parathyroid surgeries, a cost comparison between the current testing system at a university-affiliated tertiary care facility (Elecsys 1010, Roche Diagnostics, Basel, Switzerland) and a theoretical model using the QuiCK-intraoperative intact PTH system (Nichols Institute Diagnostics, San Juan Capistrano, CA) was generated. RESULTS: The cost per surgery of central laboratory-based PTH testing was $129.15 compared with $550.98 for the point of care-based system. Costs were calculated accounting for the purchase price of equipment, cost of reagents and processing, and laboratory technician time. CONCLUSIONS: This is the first cost comparison study using a Canadian-based health care model for point of care versus central laboratory PTH testing and adds to a very limited number of cost comparison studies on this topic. This study provides evidence that in the setting of a tertiary care facility that has on-site laboratory facilities with dedicated staff, central laboratory-based PTH assays provide an efficient and cost-effective way of monitoring PTH levels during parathyroidectomy surgery.
Authors: Denise Jacob; Geeta Lal; Dena R Voss; Tami Bebber; Scott R Davis; Jeff Kulhavy; Sonia L Sugg; Anna E Merrill; Matthew D Krasowski Journal: Pract Lab Med Date: 2020-08-20